What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and veterans affairs practices

Zimmerman, Richard K.; Santibanez, Tammy A.; Janosky, Janine E.; Fine, Michael J.; Raymund, Mahlon; Wilson, Stephen; Bardella, Inis Jane; Medsger, Anne R.; Nowalk, Mary Patricia

doi:10.1016/s0002-9343(02)01421-3

Cited by 192 publications

(188 citation statements)

References 22 publications

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“…11 We have also reported that physician recommendation to be vaccinated is a significant predictor of subsequent vaccination. 2,3 Discussing the vaccine even when it is not available or indicating places where vaccine is available might help to allay fears about timely receipt of vaccine and encourage vaccination when and where vaccine is available. Furthermore, it provides an opportunity for the provider to discuss other prevention techniques (eg, frequent hand washing), containment techniques (eg, stay home if infected), and treatment strategies if the patient should contract influenza (eg, antiviral medication).…”

Section: Discussionmentioning

confidence: 99%

“…Analysis of variance, 2 and t tests were used to determine significant differences between groups, and repeated measures analysis of variance was used to determine differences across influenza seasons. P was set at Յ .05 for all tests of significance.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Previous research into barriers to adult vaccination indicates that physician recommendation is an important factor related to vaccination status, [1][2][3][4][5] and most physicians recognize the value of immunization for disease prevention. 6 Yet for adults Ն65 years, overall vaccination rates of 63% for influenza and 55% for pneumococcal polysaccharide vaccine (PPV) 7 remain substantially below the 90% goal set by Healthy People 2010.…”

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confidence: 99%

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Missed Opportunities to Vaccinate Older Adults in Primary Care

Nowalk

Zimmerman²,

Cleary³

et al. 2005

The Journal of the American Board of Family Medicine

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Objective: During the 2000 to 2001 influenza season, distribution of influenza vaccine was delayed, and national self-reported vaccination rates declined. The purposes of this study were to characterize missed opportunities for adult vaccinations and assess the impact of the vaccine delay on missed opportunities for influenza vaccination as recorded in medical records.Methods: In a cross-sectional analysis, medical record data from 217 adult patients aged >65 years in primary care practices that received influenza vaccine supplies late in 2000 were used to assess rates and missed opportunities to vaccinate. Missed opportunities were defined as visits in which there was no record that vaccine had been given, discussed, or refused by the patient.Results

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Section: Discussionmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

mentioning

confidence: 99%

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Missed Opportunities to Vaccinate Older Adults in Primary Care

Nowalk

Zimmerman²,

Cleary³

et al. 2005

The Journal of the American Board of Family Medicine

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“…10,11 Disease burden was also computed from the survey portion of the MCBS. On the MCBS, subjects are asked a series of yes/no questions on the presence of a variety of chronic diseases.…”

Section: 23mentioning

confidence: 99%

Predictors of Influenza Immunization in Persons over Age 65

Xakellis¹

2005

The Journal of the American Board of Family Medicine

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Background: Numerous individual characteristics have been found to be associated with rates of obtaining flu shots. This study creates a predictive model that assesses the relative impact of each of these factors on increasing rates of flu shots in a population.Methods: The Medicare beneficiary survey from 1998 and 1999 was used. Sixteen factors present in 1998 were compared between subjects who did and who did not receive flu shots. Significant factors were then used in a logistic regression to predict the probability of receiving a flu shot in 1998 and 1999.Results: Seven demographic and 7 health status measures were significantly different between subjects who did and who did not receive flu shots in 1998. Logistic regression showed that twelve of these variables were associated with a subject receiving a flu shot in 1998 and explained 11.4% of the variability in who did and who did not receive a flu shot. For the following year, 1999, 7 measures were significantly associated with receiving a flu shot and explained 64% of the variability in who did and who did not receive a flu shot. One variable, if the subject had received a flu shot in 1998, was highly predictive of a subject receiving a flu shot in 1999, explaining 63% of the observed variability in who did and who did not receive a flu shot in 1999.

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“…A recent national survey of medical subspecialty practices demonstrated that influenza vaccine was significantly less likely to be available in cardiology practices than either endocrinology or pulmonology practices, 12 suggesting that individuals with cardiovascular disease may face greater barriers to receipt of influenza vaccine than those with other common high-risk medical conditions. Several other modifiable factors may influence the probability that an individual receives influenza vaccine in a given year, including the presence of standing orders, 13,14 the strength of physician recommendation to receive the vaccine, [15][16][17] and patient acceptance of the vaccine. 18 Approximately 12.5 million adults < 65 years old with cardiovascular disease have indications to receive influenza vaccine annually.…”

Section: Introductionmentioning

confidence: 99%

Delivery of Influenza Vaccine to Nonelderly Persons with Cardiovascular Disease, with Varying National Supply of Vaccine: A Decision Analysis

Gopal¹,

Davis²

2005

Human Vaccines

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Influenza immunization rates among non-elderly persons at high-risk for influenza are far below target levels in the United States. Provision of influenza vaccine at subspecialty practices can target high-risk patients, particularly during influenza vaccine shortages. We conducted a decision analysis to explore the potential effects on non-elderly cardiac patients' immunization rates of improving vaccine availability, standing orders rates, and physicians' vaccine recommendation rates in cardiology, primary care, and other medical subspecialty outpatient practices. We considered two supply circumstances (sufficient versus 50% of needed supply), and also incorporated community and hospital based vaccine delivery as well as patient acceptance in the model. With sufficient vaccine supply, optimized performance of cardiology practices (maximum vaccine availability, strong physician recommendations, and standing orders) yielded greater improvement in vaccine coverage rate than with separately optimized performance in primary care, pulmonology, or endocrinology practices. With only 50% of needed vaccine supply, reallocation of doses from community sites to primary care and cardiology, pulmonology, and endocrine offices yielded higher estimated immunization rates in the target population than strategies without reallocation. Only with simultaneous interventions across primary care, subspecialty care, inpatient, and community domains did immunization rates exceed 60%. Targeted interventions to optimize delivery of influenza vaccine in cardiology practices may be the most effective means of raising vaccine coverage levels among non-elderly cardiovascular patients, in times of varying national vaccine supply.

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What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and veterans affairs practices

Cited by 192 publications

References 22 publications

Missed Opportunities to Vaccinate Older Adults in Primary Care

Missed Opportunities to Vaccinate Older Adults in Primary Care

Predictors of Influenza Immunization in Persons over Age 65

Delivery of Influenza Vaccine to Nonelderly Persons with Cardiovascular Disease, with Varying National Supply of Vaccine: A Decision Analysis

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