是什么导致了延迟？新西兰免疫接种及时性的初级保健决定因素。

What contributes to delays? The primary care determinants of immunisation timeliness in New Zealand.

作者信息

Petousis-Harris Helen, Grant Cameron C, Goodyear-Smith Felicity, Turner Nikki, York Deon, Jones Rhys, Stewart Joanna

机构信息

Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, PB 92019, Auckland, New Zealand.

出版信息

J Prim Health Care. 2012 Mar 1;4(1):12-20.

PMID:22377545

Abstract

INTRODUCTION

Delay in receipt of the first vaccine dose in the primary series is one of the strongest and most consistent predictors of subsequent incomplete immunisation.

AIM

To describe the on-time immunisation delivery of New Zealand infant scheduled vaccines by primary care practices and identify characteristics of practices, health professionals and patients associated with delays in receipt of infant immunisations.

METHODS

Timeliness of immunisation delivery and factors associated with timely immunisation were examined in 124 randomly selected primary care practices in two large regions of New Zealand.

RESULTS

A multiple regression model of demographic, practice, nurse, doctor and caregiver association explained 68% of the variance in immunisation timeliness between practices. Timeliness was higher in practices without staff shortages (ß-coefficient -0.0770, p= 0.01), where nurses believed parental apathy (ß-coefficient 0.0819, p=0.008) or physicians believed parental access (ß-coefficient 0.109, p=0.002) was a barrier, and lower in practices with Maori governance (ß-coefficient -0.0868, p=0.05), higher social deprivation (ß-coefficient -0.0643, <0.001) and where caregivers received immunisation-discouraging information (ß-coefficient -0.0643, p=0.04).

DISCUSSION

Interventions supporting practice teams and providers in primary care settings could produce significant improvements in immunisation timeliness.

摘要

引言

在初次免疫系列中延迟接种第一剂疫苗是后续免疫接种不完全的最有力且最一致的预测因素之一。

目的

描述新西兰初级保健机构对婴儿计划疫苗的按时接种情况，并确定与婴儿免疫接种延迟相关的机构、卫生专业人员和患者的特征。

方法

在新西兰两个大区域随机选取124家初级保健机构，检查免疫接种的及时性以及与按时接种相关的因素。

结果

一个关于人口统计学、机构、护士、医生和照顾者关联的多元回归模型解释了各机构间免疫接种及时性差异的68%。在没有人员短缺的机构中及时性更高（β系数 -0.0770，p = 0.01），在护士认为家长冷漠（β系数 0.0819，p = 0.008）或医生认为家长难以接触（β系数 0.109，p = 0.002）是障碍的机构中及时性更高，而在有毛利人管理的机构中及时性较低（β系数 -0.0868，p = 0.05），社会剥夺程度较高（β系数 -0.0643，<0.001）以及照顾者收到不利于免疫接种信息的机构中及时性较低（β系数 -0.0643，p = 0.04）。