Referral of emergency department patients for pneumococcal vaccination.
OBJECTIVE
To determine what proportion of eligible patients, when referred to a primary care physician for pneumococcal vaccination with a prescription, actually obtain the vaccination. To ascertain the number of eligible patients who would receive the vaccination in the emergency department (ED), if available.


METHODS
The authors surveyed a convenience sample of patients presenting to an urban ED during a four-month period. Eligible patients were referred to specific sites with a prescription to be immunized. Data on those referred were collected by review of medical record and telephone follow-up.


RESULTS
A total of 2,299 surveys were distributed; 338 patients declined to participate, yielding an 85% response rate. The total number of patients identified as having an indication for the pneumovax was 711 (36%). Of these, 411 were not previously vaccinated; 167 of the 411 had a contraindication to vaccination. The remaining 244 qualified for referral to receive the pneumococcal vaccine. One hundred thirty-one of these accepted referral prescription. Of the patients given prescriptions, 12 followed up and received the vaccine, 81 did not follow up, and 38 were lost to follow-up. Seventy-four percent of patients would have received the pneumovax in the ED if it had been available.


CONCLUSIONS
The percentage of ED patients who used prescription referral to the primary care network for pneumococcal vaccination was approximately 10%. The use of a referral by prescription method in this setting was not a reliable means of increasing the number of patients receiving the pneumococcal vaccination.
Department of Emergency Medicine, Wake Forest University Baptist Medical Center, Winston-Salem, NC 27157-1089, USA. dmanthey@wfubmc.edu
David E
DE
Manthey
Jason
J
Stopyra
Kim
K
Askew
D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*
D022242:Pneumococcal Vaccines