title: The effect of patient characteristics upon uptake of the influenza vaccination: a study comparing community-based older adults in two healthcare systems.
abstract: BACKGROUND
  the uptake of influenza vaccination represents a simple marker of proactive care of older people. However, many still do not receive the vaccine. To understand this challenge better, we investigated the relationship between patient characteristics (demographic, physical and psychological health and health service use) and vaccination uptake in a sample of community-dwelling older people in two adjacent but differently structured healthcare systems (Northern Ireland (NI) and the Republic of Ireland (RoI)).
  
  
  METHODS
  a total of 2,033 randomly selected community-dwelling older adults (65 years and older) were interviewed in their homes.
  
  
  RESULTS
  rates of uptake were 78% in NI and 72% in RoI. The uptake was greater with older age (odds ratio (OR) 1.6, 95% confidence interval (CI) = 1.3-2.1, P < 0.0005), widowhood (OR = 1.5, 95% CI = 1.1-2.3, P = 0.02), living in NI (OR = 0.77, 95% CI = 0.6-0.9, P = 0.04), greater functional impairment (OR RoI 2.0, 95% CI = 0.8-3.5, P = 0.03), more frequent use of family doctor (OR RoI 0.5, 95% CI = 0.3-0.6, P = 0.0001; NI 0.6, 95% CI = 0.4-0.9, P = 0.01) and greater use of services such as chiropody (OR NI 0.6, 95% CI = 0.4-0.9, P = 0.01), meals-on-wheels (OR RoI 1.3, 95% CI = 0.4-2.2, P = 0.03), social work (OR RoI 1.2, 95% CI = 0.3-1.9, P = 0.05) and occupational therapy (OR RoI 1.3, 95% CI = 0.5-2.5, P = 0.02).
  
  
  CONCLUSIONS
  the uptake rates in both healthcare systems exceeded targets. Higher rates of vaccination were found among older people, those who were married and those who made greater use of hospital and community services. Increased exposure to health services may enhance trust in health care leading to higher vaccination uptake.
authors.affiliation: Geriatric Medicine, The Queen's University of Belfast, Whitla Medical Building, Belfast BT9 7BL, UK. v.crawford@qub.ac.uk
authors.forename: Vivienne Lynda Shirley
authors.initials: VL
authors.lastname: Crawford
authors.forename: Ann
authors.initials: A
authors.lastname: O'Hanlon
authors.forename: Hannah
authors.initials: H
authors.lastname: McGee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018672:Community Health Planning / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007252:Influenza Vaccines; D007494:Ireland; D008297:Male; D017533:Marital Status; D008603:Mental Health; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010358:Patient Participation; D012923:Social Class
chemical_list: D007252:Influenza Vaccines