slide1 l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Factors Affecting Influenza and Pneumococcal Vaccination Acceptance Among Emergency Department Patients PowerPoint Presentation
Download Presentation
Factors Affecting Influenza and Pneumococcal Vaccination Acceptance Among Emergency Department Patients

Loading in 2 Seconds...

play fullscreen
1 / 30

Factors Affecting Influenza and Pneumococcal Vaccination Acceptance Among Emergency Department Patients - PowerPoint PPT Presentation


  • 327 Views
  • Uploaded on

Factors Affecting Influenza and Pneumococcal Vaccination Acceptance Among Emergency Department Patients Diane Rimple, MD May 11, 2004 Acknowledgements Daniel Fishbein, MD Meghan Brett, MD Prevention in EDs EDs as a source of primary care: Number without health insurance is increasing

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Factors Affecting Influenza and Pneumococcal Vaccination Acceptance Among Emergency Department Patients' - oshin


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Factors Affecting Influenza and Pneumococcal Vaccination Acceptance Among Emergency Department Patients

Diane Rimple, MD

May 11, 2004

acknowledgements
Acknowledgements
  • Daniel Fishbein, MD
  • Meghan Brett, MD
prevention in eds
Prevention in EDs
  • EDs as a source of primary care:
    • Number without health insurance is increasing
    • Those who seek care in EDs are more likely to be underinsured
    • The underinsured are less likely to receive preventive health care
patient barriers to vaccination
Patient Barriers to Vaccination
  • Knowledge
  • Attitudes
  • Behavior
system barriers to vaccination
System Barriers to Vaccination
  • Knowledge
  • Attitudes
  • Behavior
purpose of study
Purpose of Study
  • Identify and eliminate barriers
  • Determine acceptance rates
  • Evaluate the cost
unm background
UNM Background
  • Only teaching hospital and Level 1 Trauma Center in New Mexico
  • 60,000 visits per year
  • 13% of patients are insured
  • Large Latino and Native American populations
eliminating the barriers
Eliminating the Barriers

We tried to eliminate as many as possible:

  • Awareness
  • Language
  • Opportunity
  • Cost
description of intervention
Description of Intervention
  • Timing: three weeks in Dec. 2003
  • Assessment and vaccination by medical students
    • trained to give vaccinations
    • taught the indications and contraindications
    • paid to work four hour “shifts”
description of intervention11
Description of Intervention
  • All patients asked if they were interested in talking about vaccination
  • Screened by medical students for risks for these diseases using CDC “Assessment-reminder form”
description of intervention12
Description of Intervention
  • Vaccinated if
    • Fulfilled ACIP criteria
    • Not already up-to date
    • No contraindications
    • Agreed
  • Process occurred prior to being seen for their chief complaint
  • Did not interfere with their care
results
Results
  • Between Dec 1 and Dec 21, 4254 patients were seen in the UNM ED.
  • 916 (21.5%) were under 18 years old
  • 163 (4.9%) were triaged as critical
  • 931 (29.3%) presented outside the study times
  • Leaving 2244 eligible patients
results14
Results
  • 684 patients were interviewed
  • 524 had ACIP indication for influenza or pneumococcal vaccine
    • 220 influenza only (15 UTD)
    • 63 pneumococcal only (5 UTD)
    • 241 both vaccines (14 UTD for both)
post intervention influenza vaccination coverage age group and patient attitude
Post Intervention Influenza Vaccination Coverage Age Group and Patient Attitude

2010 Targets

Under 50 50 to 64 65 and older

pneumococcal vaccine coverage by age group and pre interview belief
Pneumococcal Vaccine Coverageby Age Group and Pre-interview Belief

2010 Targets

Under 50 50 to 64 65 and older

insurance status and vaccination
Insurance Status and Vaccination

Influenza Pneumococcal

insurance status and vaccination22
Insurance Status and Vaccination

Influenza Pneumococcal

conclusions
Conclusions

The Need:

  • 524 of 684 (77%) patients presenting to the ED for other complaints qualified for the vaccines
conclusions24
Conclusions

Knowledge Barriers:

  • Many at risk people did not know that they were at risk.
  • Language, in our community, was NOT a barrier: Spanish speaking patients had equal (low) rates of vaccination coming into our project.
conclusions25
Conclusions

Patient Attitude Barriers:

  • Once they were informed that they were at risk, the vast majority of them agreed to immunization
conclusions26
Conclusions

Patient Behavior Barriers:

  • When vaccination was offered, rates rose from well below to well above the recommended levels.
  • We found that language did not seem to be a barrier: ALL patients had low rates prior to the project.
conclusions27
Conclusions

System Behavior Barriers:

  • Our program was designed to be supplemental to the standard ED care.
  • This would be difficult to accomplish with regular ED staffing.
    • Medical students provided inexpensive, eager and reliable manpower, but needed training and back up.
conclusions28
Conclusions

System Knowledge and Attitude Barriers:

  • These were minimal at our institution: general agreement that
    • Vaccinations are needed
    • With help, the ED is a great place to give them
conclusions29
Conclusions

Patient Barrier: Cost

  • The only significant predictor of vaccination status prior to the study was insurance status.
conclusions30
Conclusions
  • Start up required time and involvement at the faculty level.
  • Success depended on familiarity
  • Sustainability will depend on
    • Support from administration
    • Demonstrating ability
    • Cost effectiveness