A growing number of elderly men and women are dying from influenza and pneumonia, despite the fact that safe and effective vaccines against both conditions are readily available for adult patients. Moreover, Medicare covers the cost of both vaccines. Through 2001, only 63 to 65 percent of elderly individuals in the United States had been vaccinated against both diseases.
Patient factors are more important than practice factors in immunization rates. However, practices that allot more time for acute care visits and use more immunization promotion activities have higher vaccination rates, according to a study that was supported by the Agency for Healthcare Research and Quality (HS09874).
Practices that allotted 16-20 minutes versus 10-15 minutes for acute care visits had 2.5 times higher influenza vaccination rates. Practices that did not have a source of free vaccines had 57 percent fewer influenza vaccinations. Practices that were urban/suburban and had a source of free flu vaccines had four times more influenza vaccinations. Practices that had three or more vs. none to two immunization promotion strategies (for example, designated vaccination clinics, computerized immunization tracking systems, prompts on patient charts, and a source of free or reduced-cost vaccinations) had twice as many pneumonia vaccinations. Also, practices that allotted 16-20 minutes versus 10-15 minutes for acute care visits had nearly twice as many pneumonia vaccinations.
However, when practice and patient factors were combined in the analyses, patients' attitudes and knowledge about vaccines were more important, notes Mary Patricia Nowalk, Ph.D., of the University of Pittsburgh, lead author of the study. The study findings were based on analysis of interviews with 946 patients and responses of managers of 22 office practices to self-administered questionnaires about office practices and logistics affecting immunizations.
See "The physician's office: Can it influence adult immunization rates?" by Dr. Nowalk, Inis J. Bardella, M.D., Richard K. Zimmerman, M.D., and Shunhua Shen, M.S., in the January 2004 American Journal of Managed Care 10(1), pp. 13-19.