Nichol K L
Section of General Internal Medicine, Veterans Administration Medical Center, Minneapolis, Minnesota 55417.
Am J Med. 1991 Dec;91(6):584-8. doi: 10.1016/0002-9343(91)90210-o.
In 1987, the Minneapolis Veterans Affairs Medical Center implemented an ongoing, multifaceted influenza vaccination program that targeted all high-risk outpatients followed at the medical center. While the program achieved and sustained vaccination rates of 60% or more for high-risk outpatients, vaccination rates for high-risk inpatients continued to be 25% or less. Beginning with the 1989-1990 immunization season, the "flu shot" program was extended to include all high-risk inpatients. Both the outpatient and inpatient components of the Minneapolis Flu Shot Program emphasized administrative and organizational elements. The program's goal was to achieve vaccination rates of at least 60% for both high-risk outpatients and inpatients. This study assesses the effectiveness of the inpatient program among elderly patients hospitalized on the medical service during the immunization season.
To estimate patient risk characteristics and vaccination rates, 50% of elderly patients who were discharged from the medical service during the immunization season were surveyed using a validated postcard questionnaire. Their responses were compared with the responses of elderly patients to the annual outpatient survey conducted to assess the "flu shot" program.
Overall, 78.6% of elderly respondents discharged from the medical service during the immunization season were vaccinated. Vaccination rates within various high-risk subgroups all exceeded 70%. None of these vaccination rates for inpatient groups differed significantly from the rates for corresponding outpatients.
An outpatient "flu shot" program that emphasizes administrative and organizational elements can be successfully expanded to high-risk inpatients. The vaccination rates attained with such a program may not only achieve but exceed the national health objective for influenza vaccination.
1987年，明尼阿波利斯退伍军人事务医疗中心实施了一项持续的、多方面的流感疫苗接种计划，目标是针对该医疗中心随访的所有高危门诊患者。虽然该计划使高危门诊患者的疫苗接种率达到并维持在60%或更高，但高危住院患者的疫苗接种率仍持续在25%或更低。从1989 - 1990年免疫季节开始，“流感疫苗注射”计划扩大到包括所有高危住院患者。明尼阿波利斯流感疫苗注射计划的门诊和住院部分都强调管理和组织要素。该计划的目标是使高危门诊患者和住院患者的疫苗接种率至少达到60%。本研究评估了免疫季节期间在医疗科室住院的老年患者中住院计划的有效性。
为了估计患者的风险特征和疫苗接种率，使用经过验证的明信片问卷对免疫季节期间从医疗科室出院的50%老年患者进行了调查。将他们的回答与老年患者对为评估“流感疫苗注射”计划而进行的年度门诊调查的回答进行比较。
总体而言，免疫季节期间从医疗科室出院的老年受访者中有78.6%接种了疫苗。各个高危亚组的疫苗接种率均超过70%。住院患者组的这些疫苗接种率与相应门诊患者组的接种率均无显著差异。
一个强调管理和组织要素的门诊“流感疫苗注射”计划可以成功扩展到高危住院患者。通过这样一个计划实现的疫苗接种率不仅可以达到，而且可能超过国家流感疫苗接种的健康目标。
