title: Use of Seasonal Influenza Vaccination and Its Associated Factors among Elderly People with Disabilities in Taiwan: A Population-Based Study.
abstract: BACKGROUND
  Influenza immunization among elderly people with disabilities is a critical public health concern; however, few studies have examined the factors associated with vaccination rates in non-Western societies.
  
  
  METHODS
  By linking the National Disability Registration System and health service claims dataset from the National Health Insurance program, this population-based study investigated the seasonal influenza vaccination rate among elderly people with disabilities in Taiwan (N = 283,172) in 2008. A multivariate logistic regression analysis was conducted to adjust for covariates.
  
  
  RESULTS
  Nationally, only 32.7% of Taiwanese elderly people with disabilities received influenza vaccination. The strongest predictor for getting vaccinated among older Taiwanese people with disabilities was their experience of receiving an influenza vaccination in the previous year (adjusted odds ratio [AOR] = 6.80, 95% confidence interval [CI]: 6.67-6.93). Frequent OPD use (AOR = 1.85, 95% CI: 1.81-1.89) and undergoing health examinations in the previous year (AOR = 1.66, 95% CI: 1.62-1.69) also showed a moderate and significant association with receiving an influenza vaccination.
  
  
  CONCLUSIONS
  Although free influenza vaccination has been provided in Taiwan since 2001, influenza immunization rates among elderly people with disabilities remain low. Policy initiatives are required to address the identified factors for improving influenza immunization rates among elderly people with disabilities.
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC.|Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan, ROC.
authors.forename: Yu-Chia
authors.initials: YC
authors.lastname: Chang
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC.
authors.forename: Ho-Jui
authors.initials: HJ
authors.lastname: Tung
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC.|Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan, ROC.
authors.forename: Shang-Wei
authors.initials: SW
authors.lastname: Hsu
authors.affiliation: Department of Health and Kinesiology, Texas A&M University, College Station, Texas, United States of America.
authors.forename: Lei-Shin
authors.initials: LS
authors.lastname: Chen
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC.
authors.forename: Pei-Tseng
authors.initials: PT
authors.lastname: Kung
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan, ROC.
authors.forename: Kuang-Hua
authors.initials: KH
authors.lastname: Huang
authors.affiliation: Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC.
authors.forename: Shang-Jyh
authors.initials: SJ
authors.lastname: Chiou
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan, ROC.
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Tsai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D017589:Immunization Programs; D007252:Influenza Vaccines / Q000276:immunology; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D016017:Odds Ratio; D011159:Population Surveillance; D012042:Registries; D012307:Risk Factors; D012621:Seasons; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D014611:Vaccination
chemical_list: D007252:Influenza Vaccines