title: Improving influenza vaccination rates in the elderly.
abstract: BACKGROUND
  Vaccination coverage for influenza in the elderly remains low when the physician is the only person responsible for immunization. Integration of other health care workers may improve the coverage rate of at-risk groups.
  
  
  OBJECTIVE
  To estimate vaccination coverage rate by using a strategy based on the systematic intervention of a health care professional proposing vaccination before the doctor's consultation, to evaluate the changes in coverage rates before and after introduction of this strategy, and to assess the feasibility of this intervention and the achieved coverage rate in family physician offices.
  
  
  METHODS
  Prospective study in a medical outpatient clinic and 5 family physician practices in Switzerland.
  
  
  METHODS
  Participants consisted of all patients 65 years or older attending a medical outpatient clinic during the vaccination period in 1999 (n = 401), patients 65 years or older regularly followed at a medical outpatient clinic in 1998 and 1999 (n = 195), and patients 65 years or older presenting to 5 family physician offices in 1999 (n = 598).
  
  
  METHODS
  Rates of vaccination coverage.
  
  
  RESULTS
  Among all participants, vaccination coverage rates in 1999 were 85% at the medical outpatient clinic and 83% in family physician offices. Among participants regularly followed at the medical outpatient clinic, vaccination coverage increased from 48% in 1998 to 76% in 1999. Rates of refusal were 9% at the medical outpatient clinic and 14% in the family physician offices.
  
  
  CONCLUSIONS
  The systematic intervention of a health care professional to suggest vaccination before the doctor's visit is an effective measure to achieve high coverage rate. Such a strategy also improves outpatient clinic or private practice efficiency by reducing pressures on physicians.
authors.affiliation: Medical Outpatient Clinic, University of Lausanne, Lausanne, Switzerland.
authors.forename: Myriam
authors.initials: M
authors.lastname: Birchmeier
authors.forename: Bernard
authors.initials: B
authors.lastname: Favrat
authors.forename: Alain
authors.initials: A
authors.lastname: Pécoud
authors.forename: Gilbert
authors.initials: G
authors.lastname: Abetel
authors.forename: Michel
authors.initials: M
authors.lastname: Karly
authors.forename: Pierre
authors.initials: P
authors.lastname: Landry
authors.forename: Maxime
authors.initials: M
authors.lastname: Mancini
authors.forename: François
authors.initials: F
authors.lastname: Verdon
authors.forename: Blaise
authors.initials: B
authors.lastname: Genton
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D010353:Patient Education as Topic; D011446:Prospective Studies; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines