title: A coordinated, communitywide program in Monroe County, New York, to increase influenza immunization rates in the elderly.
abstract: BACKGROUND
  Despite the efficacy of influenza vaccination in preventing complications of influenza, rates of immunization among high-risk populations remain low. The Monroe County (New York) Influenza Vaccination Demonstration was a communitywide, collaborative effort to increase the rates of influenza immunization to greater than 60% in elderly Medicare recipients.
  
  
  METHODS
  The local health department, university medical center, and practicing physicians collaborated to develop a communitywide demonstration directed to all Medicare part B enrollees 65 years of age or older, multiple coordinated approaches were used over a 4-year period (1988 to 1992). Most providers, including public agencies, private providers, hospital outpatient facilities, nursing homes, and insurance providers, were enrolled in a comprehensive program that included centralized claims processing, vaccine distribution and promotion, and extensive provider and public education efforts, including a special urban outreach program. An office-based, denominator-driven physician incentive project was also evaluated.
  
  
  RESULTS
  The demonstration project resulted in a 1991 influenza immunization rate of 74.3% among 88,811 Medicare enrollees 65 years of age or older. The increase in immunization rate occurred primarily among the patients of private physicians.
  
  
  CONCLUSIONS
  A communitywide, collaborative approach can succeed in achieving high rates of influenza immunization.
authors.affiliation: Monroe County Health Department, NY.
authors.forename: N M
authors.initials: NM
authors.lastname: Bennett
authors.forename: B
authors.initials: B
authors.lastname: Lewis
authors.forename: A S
authors.initials: AS
authors.lastname: Doniger
authors.forename: K
authors.initials: K
authors.lastname: Bell
authors.forename: R
authors.initials: R
authors.lastname: Kouides
authors.forename: F M
authors.initials: FM
authors.lastname: LaForce
authors.forename: W
authors.initials: W
authors.lastname: Barker
mesh_terms: D000368:Aged; D005260:Female; D006785:Hospitals, University; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D006278:Medicare; D009518:New York; D010821:Physicians, Family; D011635:Public Health Administration; D014481:United States