A Map of Racial and Ethnic Disparities in Influenza Vaccine Uptake in the Medicare Fee-for-Service Program
A Map of Racial and Ethnic Disparities in Influenza Vaccine Uptake in the Medicare Fee-for-Service Program
复制标题
DOI：
10.1007/s12325-020-01324-y
复制
发表时间：
2020-05-01
影响因子：
3.8
通讯作者：
Chit, Ayman
中科院分区：
文献类型：
--
作者：
Hall, Laura L.;Xu, Liou;Chit, Ayman
简介 尽管人们对流感风险的了解有所提高，并且为老年患者提供了更好的疫苗，但流感疫苗接种率仍然低于标准，包括老年人等高风险群体，并且表现出显着的种族和民族差异。方法 本研究考虑了 2015-2016 年医疗保险按服务收费 (FFS) 受益人流感疫苗接种的人口、临床和地理相关性，并将数据映射到邮政编码级别的地理信息系统 (GIS) 上。结果分析证实，只有一半的高级受益人证明声称接受了灭活流感疫苗（IIV），黑人、西班牙裔、农村和较贫困受益人之间存在显着差异。高剂量（HD）疫苗观察到更广泛的差异，它为老年人群提供了额外的保护，并证实了经济效益。大多数白人受益人获得了 HD；没有非白人亚群体这样做。数据绘制证实了弱势群体的疫苗接种情况低于标准，并且在邮政编码层面存在很大差异。结论 需要采取紧急和有针对性的努力来公平地提高 IIV 费率，从而保护最弱势群体免受流感对健康的负面影响，并保护纳税公众免受医疗保险费用的影响。
Introduction Despite improved understanding of the risks of influenza and better vaccines for older patients, influenza vaccination rates remain subpar, including in high-risk groups such as older adults, and demonstrate significant racial and ethnic disparities. Methods This study considers demographic, clinical, and geographic correlates of influenza vaccination among Medicare Fee-for-Service (FFS) beneficiaries in 2015-2016 and maps the data on a geographic information system (GIS) at the zip code level. Results Analyses confirm that only half of the senior beneficiaries evidenced a claim for receiving an inactivated influenza vaccine (IIV), with significant disparities observed among black, Hispanic, rural, and poorer beneficiaries. More extensive disparities were observed for the high-dose (HD) vaccine, with its added protection for older populations and confirmed economic benefit. Most white beneficiaries received HD; no non-white subgroup did so. Mapping of the data confirmed subpar vaccination in vulnerable populations with wide variations at the zip code level. Conclusion Urgent and targeted efforts are needed to equitably increase IIV rates, thus protecting the most vulnerable populations from the negative health impact of influenza as well as the tax-paying public from the Medicare costs from failing to do so.