Clinical studyWhat affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and veterans affairs practices☆
Section snippets
Subjects
We selected patients using a two-stage, stratified, random cluster sampling method (11). In the rural and suburban strata, random samples of practices were selected. All inner-city and VA practices were selected because of small numbers. From each selected practice, all eligible physicians were included; eligibility criterion was having a practice consisting of >50% primary care patients. This resulted in a sample of eight rural practices with 15 clinicians, nine suburban practices with 19
Results
We sent requests for participation to 1642 persons and found 259 to be ineligible or with invalid telephone numbers, leaving 1383 potential respondents. When we concluded interviewing, we had 1007 completed interviews (Table 1), 227 refusals, and 149 persons whom we were unable to contact, which yielded a response rate of 73%.
Nine respondents reported not knowing their vaccination status and were excluded from analyses on vaccination status. Overall, 79% (n = 787) of respondents reported being
Discussion
Nearly every elderly person who was vaccinated in the 1999-2000 season said that they planned to be vaccinated the next year, compared with only one quarter of those who were not vaccinated. We found that intention was the strongest predictor of behavior. Other key factors were knowledge of Medicare payment for the vaccine, belief that being vaccinated was a wise decision, belief in the vaccine’s efficacy, and belief that others (especially one’s doctor) recommended vaccination. Economics,
Acknowledgements
We thank Seymour Grufferman, MD, DrPH, for his advice and guidance on this project.
This paper was presented in part at the Distinguished Papers Session, Research Forum, Society of Teachers of Family Medicine Annual Meeting, San Francisco, April 27–May 1, 2002.
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Funded by HS09874 from the Agency for Healthcare Research and Quality, Rockville, Maryland.