Association of provider recommendation and offer and influenza vaccination among adults aged ≥18 years - United States
Association of provider recommendation and offer and influenza vaccination among adults aged ≥18 years - United States
复制标题
DOI：
10.1016/j.vaccine.2017.12.016
复制
发表时间：
2018-02-01
期刊：
影响因子：
5.5
通讯作者：
Williams, Walter W.
中科院分区：
文献类型：
--
作者：
Lu, Peng-jun;Srivastav, Anup;Williams, Walter W.
背景资料：自2010年以来，建议所有年龄≥ 6个月的人接种流感疫苗。方法：分析2016年全国互联网流感调查的数据，以评估2016-17年流感季期间≥ 18岁成人的疫苗接种建议和早期流感疫苗接种。来自多变量逻辑回归模型的预测边际被用于通过提供者疫苗接种推荐状态来识别与早期疫苗摄取独立相关的因素。总体而言，24.0%的人拜访了既推荐又提供流感疫苗接种的提供者，9.0%的人拜访了只推荐但不提供疫苗接种的提供者，25.1%的人拜访了既不推荐也不提供疫苗接种的提供者，41.9%的人从7月1日到访问日没有去看过医生。报告提供者既推荐又提供疫苗的成年人的疫苗接种覆盖率（66.6%）显著高于报告提供者仅推荐但不提供疫苗的成年人（48.4%），既没有收到推荐也没有提供疫苗的成年人（32.0%）以及在疫苗接种期间没有去看医生的成年人（28.8%）。多变量Logistic回归的结果表明，已收到供应商的建议，有或没有提供疫苗接种，是显着相关的较高的疫苗接种覆盖率后，控制人口和访问到护理factors.Conclusions：供应商的建议与流感疫苗接种显着相关。然而，总体而言，67.0%的成年人在疫苗接种期间没有去看医生，或者去看了医生，但没有收到提供者的建议。应采取循证策略，如客户提醒/召回、长期订单、提供者提醒或卫生系统干预措施，以改善提供者的建议和流感疫苗接种覆盖率。与流感疫苗接种水平较高显著相关的其他因素包括年龄>= 50岁，是西班牙裔，受过大学或高等教育，有通常的医疗保健场所，以及有公共健康保险。爱思唯尔有限公司出版
Background: Influenza vaccination has been recommended for all persons aged >= 6 months since 2010.Methods: Data from the 2016 National Internet Flu Survey were analyzed to assess provider vaccination recommendations and early influenza vaccination during the 2016-17 season among adults aged >= 18 years. Predictive marginals from a multivariable logistic regression model were used to identify factors independently associated with early vaccine uptake by provider vaccination recommendation status.Results: Overall, 24.0% visited a provider who both recommended and offered influenza vaccination, 9.0% visited a provider who only recommended but did not offer, 25.1% visited a provider who neither recommended nor offered, and 41.9% did not visit a doctor from July 1 through date of interview. Adults who reported that a provider both recommended and offered vaccine had significantly higher vaccination coverage (66.6%) compared with those who reported that a provider only recommended but did not offer (48.4%), those who neither received recommendation nor offer (32.0%), and those who did not visit a doctor during the vaccination period (28.8%). Results of multivariable logistic regression indicated that having received a provider recommendation, with or without an offer for vaccination, was significantly associated with higher vaccination coverage after controlling for demographic and access-to-care factors.Conclusions: Provider recommendation was significantly associated with influenza vaccination. However, overall, 67.0% of adults did not visit a doctor during the vaccination period or did visit a doctor but did not receive a provider recommendation. Evidence-based strategies such as client reminder/recall, standing orders, provider reminders, or health systems interventions in combination should be undertaken to improve provider recommendation and influenza vaccination coverage. Other factors significantly associated with a higher level of influenza vaccination included age >= 50 years, being Hispanic, having a college or higher education, having a usual place for medical care, and having public health insurance. Published by Elsevier Ltd.