Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
复制标题
俄勒冈州疗养院的医护人员流感疫苗接种：设施特征的相关性。
DOI：
10.1016/j.jamda.2014.06.005
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发表时间：
2014
影响因子：
7.6
通讯作者：
Li,Yue
中科院分区：
文献类型：
--
作者：
Campbell,LaurenJ;Li,Qinghua;Li,Yue
目的护理之家（NH）员工流感疫苗接种与居民发病率和死亡率的降低有关。关于NH特征和员工流感疫苗接种率（EVR）之间的关联知之甚少。本研究确定了可能与EVRs.DesignData员工疫苗接种率和程序的NH特征收集自2009年至2012年3个流感季节的俄勒冈州卫生政策和研究报告办公室，并与在线调查，认证和报告文件合并，从中获得设施特征。从2010年地区卫生资源文件中获得市场控制。多变量线性和逻辑回归被用来模拟设施特征和EVR之间的关系，每个设施每年，是否对员工进行正规教育，以及是否达到2010年，2015年和2020年健康人的目标。根据2009-2010年、2010-2011年和2011-2012年调查获得的信息，计算了113/140、129/141和137/140的EVR（81%，91%和98%）的NH，分别。测量因变量为EVR每个设施每年，是否进行正式教育的员工，以及2010年、2015年和2020年健康人口目标是否实现。独立变量包括设施的特点和市场controls.ResultsOn平均，连锁附属的NH有9%的EVR（P= 0.01）和73%的几率更高，实现60%EVR（2010年的目标，P= 0.05）比独立的NH。营利性NHs的EVR平均比非营利NHs低8%（P= 0.04）。令人惊讶的是，医疗补助居民比例增加10%，EVR增加2%（P= 0.01）和更高的几率达到60%（比值比= 1.20，P = .004）和70%（2015年目标，优势比= 1.14，P = 0.05）EVR.结论考虑到卫生院员工流感疫苗接种率普遍较低，可能有必要针对业绩差的设施进行大幅度改进。然而，这项研究的重要相关性不能很容易地解决NH管理或政策制定者。如果没有鼓励疫苗接种计划关键组成部分的政策变化，公共报告可能不足以改善EVR。
ObjectivesNursing home (NH) employee influenza vaccination is associated with reductions in morbidity and mortality among residents. Little is known regarding associations between NH characteristics and employee influenza vaccination rates (EVRs). This study identifies NH characteristics that may be associated with EVRs.DesignData on employee vaccination rates and programs were gathered from the Office for Oregon Health Policy and Research reports for 3 influenza seasons from 2009 to 2012 and merged with Online Survey, Certification, and Reporting files, from which facility characteristics were obtained. Market controls were obtained from the 2010 Area Health Resource File. Multivariate linear and logistic regression were used to model relationships between facility characteristics and EVR per facility per year, whether formal education for employees was conducted, and whether 2010, 2015, and 2020 Healthy People targets were met.SettingOregon nursing homes from 2009 to 2012.ParticipantsNHs reporting sufficient data to calculate an EVR were included. Based on information obtained from 2009–2010, 2010–2011, and 2011–2012 surveys, EVRs were calculated for 113/140, 129/141, and 137/140 (81%, 91%, and 98% of) NHs, respectively.MeasurementsDependent variables were EVR per facility per year, whether formal education for employees was conducted, and whether 2010, 2015, and 2020 Healthy People targets were met. Independent variables included facility characteristics and market controls.ResultsOn average, chain-affiliated NHs had 9% higher EVRs (P= .01) and 73% higher odds of achieving 60% EVR (2010 target,P= .05) than free-standing NHs. For-profit NHs had, on average, 8% lower EVRs (P= .04) than not-for-profit NHs. Surprisingly, a 10% increase in proportion of Medicaid residents was associated with a 2% increase in EVR (P= .01) and higher odds of achieving 60% (odds ratio = 1.20,P= .004) and 70% (2015 target, odds ratio = 1.14,P= .05) EVR.ConclusionGiven that NHs generally have low employee influenza vaccination rates, it may be necessary to target low-performing facilities to achieve substantial improvements. However, significant correlates of this study cannot be easily addressed by NH management or policymakers. Without policy change encouraging key components of vaccination programs, public reporting may be insufficient to improve EVRs.