Rodgers D J, Karp S K, Woodruff S D, Wright L D, Stiles S K
Intermountain End-Stage Renal Disease Network, Inc, Denver CO, USA.
Adv Ren Replace Ther. 2000 Oct;7(4 Suppl 1):S81-4.
Billing data from the Health Care Financing Administration (HCFA) indicated that the influenza immunization rates for dialysis patients in the United States do not meet the goal of 60% set by Healthy People 2000, and fall significantly short of the goal of 90% of all Medicare beneficiaries as outlined in Healthy People 2010. Influenza and pneumonia together are the sixth leading cause of death in the United States. Despite the known benefits of influenza vaccination in reducing morbidity and mortality, only 40% to 50% of high-risk patients are immunized. Although HCFA/Medicare billing data may not provide the best measurement of actual practice, it is currently the only measure available from any national source. The data suggest that there is a need for improvement. Because the HCFA/Medicare rates were based only on those immunizations for which Medicare was billed, End-Stage Renal Disease Network 15 embarked on a project to determine a more accurate rate of immunization within the Network based on information provided by the dialysis facilities. Influenza vaccination rates for the winter 1998 flu season ranged from 51.5% to 84.9% for the states in the Network; the rate for the whole Network was 74.6%. The HCFA/Medicare billed influenza immunization rates were 26.5 to 45.6 percentage points lower.
医疗保健财务管理局（HCFA）的计费数据表明，美国透析患者的流感疫苗接种率未达到《健康人民2000》设定的60%的目标，且远低于《健康人民2010》中概述的所有医疗保险受益人的90%的目标。流感和肺炎加在一起是美国第六大死因。尽管已知流感疫苗接种在降低发病率和死亡率方面有好处，但只有40%至50%的高危患者接种了疫苗。虽然HCFA/医疗保险计费数据可能无法提供对实际情况的最佳衡量，但目前它是来自任何国家来源的唯一可用衡量标准。这些数据表明有必要进行改进。由于HCFA/医疗保险的费率仅基于那些向医疗保险计费的疫苗接种情况，终末期肾病网络15启动了一个项目，根据透析设施提供的信息来确定该网络内更准确的疫苗接种率。1998年冬季流感季节，该网络内各州的流感疫苗接种率在51.5%至84.9%之间；整个网络的接种率为74.6%。HCFA/医疗保险计费的流感疫苗接种率低26.5至45.6个百分点。
