The American Journal of Managed Care

Using Administrative Claims to Identify Children With Chronic Conditions in a Statewide Immunization Registry | Page 4

Published Online: May 20, 2014
Kevin J. Dombkowski, DrPH, MS; Lauren Costello, MSW; Shiming Dong, MS; and Sarah J. Clark, MPH
Our findings should be considered in light of several limitations. We were unable to evaluate the accuracy and completeness of the commercial healthcare claims data used to populate the high risk indicator in MCIR. Consequently, we were therefore unable to verify the accuracy of using the administrative claims data from the commercial health plans in identifying children with chronic conditions. Additionally, although this study examined missed opportunities among children with chronic conditions, we are unable to determine why missed opportunities occur. Furthermore, because our study intended to demonstrate the feasibility of using administrative data to identify children with chronic conditions, children were included in our sample if they had at least 1 claim for a chronic condition regardless of the number of provider encounters, severity, or duration of the condition. Future studies examining the accuracy, feasibility, and utility of using administrative claims data should also take into account the severity of chronic condition by subdividing children with chronic conditions into complexity groups. Finally, it should be noted that substantial time lags were encountered with respect to executing the data-use agreements required for this study. Such delays should be considered in future studies or applications of these methods to public health practice.

In conclusion, our study found that administrative claims data can be used to identify children with chronic conditions in a statewide registry. Low vaccination rates and a high rate of missed opportunities among the children with chronic conditions in our sample suggests the utility of integrating administrative claims data with statewide registries for use of various outreach strategies, including reminder/recall aimed at parents and provider-focused reminders.

Take-Away Points

Administrative data from commercial health plans can be used to identify children with chronic conditions in a statewide immunization registry. Low influenza vaccination rates and high occurrences of missed opportunities among children with chronic conditions in our sample suggest the utility of integrating administrative claims data with statewide registries. This integration can:
  • Enable a population-based mechanism for identification of children with chronic conditions as priority cases during pandemic events or supply shortages.

  • Support various outreach strategies to improve influenza vaccination rates, including physician-focused and parent-targeted reminder/recall.
Author Affiliations: Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, MI (KJD, LC, SD, SJC).

Source of Funding: This study was supported by the Center for Healthcare Research and Transformation.

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (KJD, SJC); acquisition of data (KJD, SD); analysis and interpretation of data (KJD, LC, SD, SJC); drafting of the manuscript (KJD, LC); critical revision of the manuscript for important intellectual content (LC, SJC); statistical analysis (KJD, SD); obtaining funding (KJD); administrative, technical, or logistic support (SJC); supervision (KJD).

Address correspondence to: Kevin J. Dombkowski, DrPH, MS, University of Michigan, Division of General Pediatrics, 300 N Ingalls, Rm 6D05, Ann Arbor, MI 48109-5456. E-mail:
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Issue: May 2014
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