Fontanesi John, Hill Linda, Olson Rick, Bennett Nancy M, Kopald David
Department of Pediatrics, Division of Community Pediatrics, University of California, San Diego, La Jolla 92092-0927, USA.
J Med Pract Manage. 2006 Mar-Apr;21(5):288-94.
Influenza vaccine is a safe, effective, and cost-effective intervention that can prevent serious disease in adults. Opinions differ as to the most effective method for delivering the vaccine to the greatest number of high-risk adults. The objective of this article is to compare immunization delivery of influenza vaccine to high-risk adults during two types of clinic visits: routine scheduled appointments versus mass clinics. Data was collected at 15 ambulatory care settings on 599 patients 50 years and over from October 23, 2001, to January 31, 2002. Immunizations given at either routine scheduled visits or at mass influenza immunization clinics were compared for costs and resource requirements (productivity), and completeness of delivery of quality visit components (efficiency). The two visit types presented significantly different strengths on key clinical functions. Routine scheduled appointments promoted more review of patient health history and more of the contact information necessary for reminder/recall and audit functions. In mass immunization clinics, patients were more likely to be vaccinated, with far less time spent in either direct services or in waiting, and it was more likely that the required vaccination information statements (VIS) would be provided. Mass vaccination clinics and routine scheduled appointments are both viable service strategies for delivering influenza vaccines. This study suggests the greatest advantage occurs when both strategies are used in a coordinated manner.
流感疫苗是一种安全、有效且具有成本效益的干预措施，可预防成年人的严重疾病。对于将疫苗接种给数量最多的高危成年人的最有效方法，存在不同意见。本文的目的是比较在两种类型的门诊就诊期间，向高危成年人提供流感疫苗的免疫接种情况：常规预约就诊与大规模诊所接种。在2001年10月23日至2002年1月31日期间，在15个门诊护理机构收集了599名50岁及以上患者的数据。比较了在常规预约就诊或大规模流感免疫接种诊所进行的免疫接种的成本和资源需求（生产力），以及优质就诊环节的完成情况（效率）。这两种就诊类型在关键临床功能上呈现出显著不同的优势。常规预约就诊促进了对患者健康史的更多回顾以及更多用于提醒/召回和审核功能所需的联系信息。在大规模免疫接种诊所，患者接种疫苗的可能性更大，在直接服务或等待中花费的时间要少得多，并且更有可能提供所需的疫苗接种信息声明（VIS）。大规模疫苗接种诊所和常规预约就诊都是提供流感疫苗的可行服务策略。本研究表明，当两种策略以协调的方式使用时，优势最大。
