title: A national survey of physician practices regarding influenza vaccine.
abstract: 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.
  
  
  METHODS
  Cross-sectional mail survey administered in October and November 2000.
  
  
  METHODS
  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.
authors.affiliation: Division of General Internal Medicine, University of Michigan, Ann Arbor, Michigan 48109-0456, USA. mattdav@med.umich.edu
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Davis
authors.forename: Shawn R
authors.initials: SR
authors.lastname: McMahon
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Santoli
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schwartz
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Clark
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003625:Data Collection; D005194:Family Practice; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control*; D007388:Internal Medicine; D016015:Logistic Models; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017010:Reminder Systems; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines