Improving influenza vaccination rates in the elderly.
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.
Birchmeier
Myriam
M
Medical Outpatient Clinic, University of Lausanne, Lausanne, Switzerland.
Favrat
Bernard
B
Pécoud
Alain
A
Abetel
Gilbert
G
Karly
Michel
M
Landry
Pierre
P
Mancini
Maxime
M
Verdon
François
F
Genton
Blaise
B
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*
D007252:Influenza Vaccines