美国养老院居民中接受流感和肺炎球菌疫苗接种的种族差异。
Racial disparities in receipt of influenza and pneumococcus vaccinations among US nursing-home residents.
机构信息
Health Policy Research Institute and the Department of Medicine, University of California, Irvine, USA.
出版信息
Am J Public Health. 2010 Apr 1;100 Suppl 1(Suppl 1):S256-62. doi: 10.2105/AJPH.2009.173468. Epub 2010 Feb 10.
OBJECTIVES
We examined racial disparities in receipt and documentation of influenza and pneumococcus vaccinations among nursing-home residents.
METHODS
We performed secondary analyses of data from a nationally representative survey of White (n = 11 448) and Black (n = 1174) nursing-home residents in 2004. Bivariate and multivariate analyses determined racial disparities in receipt of influenza vaccination in 2003 and 2004, receipt of pneumococcus vaccination ever, and having a documented history for each vaccination.
RESULTS
The overall vaccination rate was 76.2% for influenza and 48.5% for pneumococcus infection. Compared with Whites, Blacks showed a 13% lower vaccination rate and a 5% higher undocumentation rate for influenza, and a 15% lower vaccination rate and a 7% higher undocumentation rate for pneumococcus. For influenza, the odds ratio (OR) for Blacks being unvaccinated was 1.84 (P < or = .001), and the OR for Blacks having undocumented vaccination was 1.85 (P = .001). For pneumococcus infection, the OR for Blacks being unvaccinated was 1.70 (P < or = .001), and the OR for Blacks having undocumented vaccination was 1.95 (P < or = .001). Stratified analyses confirmed persistent racial disparities among subpopulations.
CONCLUSIONS
Racial disparities exist in vaccination coverage among US nursing-home residents. Targeted interventions to improve vaccination coverage for minority nursing-home residents are warranted.
目的
我们研究了居住在养老院的患者在流感和肺炎球菌疫苗接种方面的种族差异。
方法
我们对 2004 年一项全国代表性的白种人（n=11448）和黑种人（n=1174）养老院居民的调查数据进行了二次分析。使用单变量和多变量分析，确定了 2003 年和 2004 年流感疫苗接种率、肺炎球菌疫苗接种史以及每次接种的记录情况。
结果
总体流感疫苗接种率为 76.2%，肺炎球菌疫苗接种率为 48.5%。与白人相比，黑人的流感疫苗接种率低 13%，未记录接种史的比例高 5%，肺炎球菌疫苗接种率低 15%，未记录接种史的比例高 7%。对于流感，黑人未接种疫苗的比值比（OR）为 1.84（P≤0.001），未记录接种史的 OR 为 1.85（P=0.001）。对于肺炎球菌感染，黑人未接种疫苗的 OR 为 1.70（P≤0.001），未记录接种史的 OR 为 1.95（P≤0.001）。分层分析证实了不同亚人群中存在持续的种族差异。
结论
美国养老院居民的疫苗接种覆盖率存在种族差异。有必要针对少数民族养老院居民采取有针对性的干预措施，以提高疫苗接种覆盖率。
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