A national survey of physician practices regarding influenza vaccine
A national survey of physician practices regarding influenza vaccine
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DOI：
10.1046/j.1525-1497.2002.11040.x
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发表时间：
2002-09-01
影响因子：
5.7
通讯作者：
Clark, SJ
中科院分区：
文献类型：
--
作者：
Davis, MM;McMahon, SR;Clark, SJ
目的：为了描述美国医生关于流感疫苗的实践，特别是关于识别高危患者的能力，提醒系统的使用，以及疫苗接种的典型时期。设计：2000年10月和11月进行的横断面邮件调查。参与者：全国随机抽样的内科医生和家庭医生（N = 1，606）。家庭医生比内科医生更有可能在他们的实践中接种流感疫苗（82%比76%; P <0.05）。80%的医生通常接种流感疫苗3至5个月，但只有27%的医生在典型的全国流感活动高峰后继续接种疫苗。只有一半的医生表示，他们的做法能够生成流感并发症高风险慢性病患者名单，只有四分之一的医生使用邮件或电话提醒系统联系高风险患者。在医生网络中工作的医生（包括管理式医疗机构）使用提醒的可能性是其他实践环境中医生的两倍多（比值比，2.04; 95%可信区间，1.17 ~ 3.55）。超过四分之三的美国内科医生和家庭医生定期接种流感疫苗，但在全国流感活动高峰期过后，很少有人继续进行免疫接种工作。许多医生可能受到其实践数据系统识别高风险患者的能力的限制。尽管提醒系统的有效性和成本效益是已知的，但很少有医生将提醒用于流感疫苗接种工作。这些发现引起了人们对满足国内流感疫苗接种目标的关注，特别是对于慢性病患者和疫苗供应延迟的时期，以及由此导致流感发病率和死亡率增加的可能性。
OBJECTIVE: To characterize U.S. physicians' practices regarding influenza vaccine, particularly regarding the capacity to identify high-risk patients, the use of reminder systems, and the typical period of administration of vaccine.DESIGN: Cross-sectional mail survey administered in October and November 2000.PARTICIPANTS: National random sample of internists and family physicians (N = 1,606).RESULTS: Response rate was 60%. Family physicians are significantly more likely than internists to administer influenza vaccine in their practices (82% vs 76%; P < .05). Eighty percent of physicians typically administer influenza vaccine for 3 to 5 months, but only 27% continue administering vaccine after the typical national peak of influenza activity. Only one half of physicians said their practices are able to generate lists of patients with chronic illnesses at high risk for complications of influenza, and only one quarter had used mail or telephone reminder systems to contact high-risk patients. Physicians working in a physician network (including managed care organizations) are more than twice as likely to use reminders as physicians in other practice settings (odds ratio, 2.04; 95% confidence interval, 1.17 to 3.55).CONCLUSIONS: Over three quarters of U.S. internists and family physicians routinely administer influenza vaccine, but few continue immunization efforts past the typical national peak of influenza activity. Many physicians may be limited by their practice data systems' capacity to identify high-risk patients. Despite the known effectiveness and cost-effectiveness of reminder systems, few physicians use reminders for influenza vaccination efforts. These findings raise concerns about meeting domestic influenza vaccination goals-especially for individuals with chronic illness and during periods of delayed vaccine availability-and the possibility of increased morbidity and mortality attributable to influenza as a result.