title: Patient characteristics determine differences in the influenza vaccination rate more so than practice features.
abstract: BACKGROUND
  World-wide each year 30-55% of the target population is vaccinated against influenza. Determinants of successful vaccination programs are not clear. This study was aimed at identifying practice- and patient-related factors that determine differences in vaccination rates.
  
  
  METHODS
  Data on patients of the target population were extracted from the computerized medical record systems of 48 family practices. Information about organizational factors was collected by a questionnaire for GP's. Multilevel logistic regression analyses were used to assess the determinants.
  
  
  RESULTS
  Of all patients at risk (42,426), 76% were vaccinated. The vaccination rate for patients above age 65 was 15% higher when a medical indication was present. Patients with cardiac diseases or diabetes mellitus attained a relatively higher vaccination rate than other groups at risk. Special hours for vaccination led to significantly higher vaccination rates for the elderly and cardiac patients. Patients below 65 years of age were particularly influenced by special information pamphlets.
  
  
  CONCLUSIONS
  Explanations of differences in uptake rates were found at the patient level. All practices in this study were well organized; nevertheless, subgroup analyses showed that special vaccination hours for elderly people and information pamphlets for young people could improve results further.
authors.affiliation: Centre for Quality of Care Research, University of Nijmegen/University of Maastricht, The Netherlands. M.Tacken@HSV.KUN.NL
authors.forename: Margot
authors.initials: M
authors.lastname: Tacken
authors.forename: Jozé
authors.initials: J
authors.lastname: Braspenning
authors.forename: Peter
authors.initials: P
authors.lastname: Spreeuwenberg
authors.forename: Henk
authors.initials: H
authors.lastname: van den Hoogen
authors.forename: Gerrit
authors.initials: G
authors.lastname: van Essen
authors.forename: Dinny
authors.initials: D
authors.lastname: de Bakker
authors.forename: Richard
authors.initials: R
authors.lastname: Grol
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006266:Health Education; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007252:Influenza Vaccines / Q000008:administration & dosage*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012307:Risk Factors; D040241:Social Marketing
chemical_list: D007252:Influenza Vaccines