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成人看护者流感疫苗接种在儿科门诊的实施:一个茧居式医疗保健改善项目。

Adult Caregiver Influenza Vaccination Through Administration in Pediatric Outpatient Clinics: A Cocooning Healthcare Improvement Project.

机构信息

From the Lucile Packard Children's Hospital, Stanford School of Medicine, Palo Alto, California.

UF Health Shands Children's Hospital, University of Florida College of Medicine, Gainesville, Florida.

出版信息

Pediatr Infect Dis J. 2018 Sep;37(9):939-942. doi: 10.1097/INF.0000000000001970.

Abstract

BACKGROUND

Pediatric exposure to influenza-infected adult caregivers (AC) is a significant risk factor for developing influenza. Poor access to vaccines contributes to low adult vaccination rates. We offered adult vaccination at regularly scheduled pediatric office visits and examined barriers to improve future vaccination rates.

METHODS

Via a retrospective chart review, we identified ACs who received an influenza vaccination at 1 of 3 pediatric clinics within an academic center from August 2015 to May 2016. We screened for demographics of ACs and their children. Rates of AC vaccination and AC refusal were not measured.

RESULTS

A total of 297 ACs representing 518 children received their influenza vaccine at their child's pediatric office. The mean age of ACs was 35.9 years (range, 22-70 years) and 68.5% were mothers. Most ACs (n = 294, 99%) receiving the vaccine had private insurance. Almost all ACs received their vaccination on the day of the child's visit (n = 250, 84%). A total of 49.6% of AC's children had high-risk illnesses. Parents of children with Medicaid were under-represented because of high parental copays (n = 3, 1%). The highest clinic vaccine participation was noted at the clinics with lowest Medicaid populations.

CONCLUSIONS

ACs readily accepted influenza vaccination at their child's pediatric primary care office. Increased vaccination acceptance occurred when ACs were female, had private insurance, if their child had a chronic illness and if the vaccination was offered the same day as their child's appointment. Likely reason for low acceptance in ACs with Medicaid insurance is high cost; thus, staff, well-aware of Medicaid's nonreimbursement, likely offered the vaccine less to these parents.

摘要

背景

儿童接触感染流感的成人照护者(AC)是患流感的一个重要危险因素。疫苗接种机会有限导致成人疫苗接种率低。我们在定期安排的儿科就诊时为成人提供疫苗接种,并检查了提高未来疫苗接种率的障碍。

方法

通过回顾性病历审查,我们确定了在 2015 年 8 月至 2016 年 5 月期间,在学术中心的 3 家儿科诊所之一接受流感疫苗接种的 AC。我们筛查了 AC 及其子女的人口统计学特征。未测量 AC 疫苗接种率和 AC 拒绝率。

结果

共有 297 名代表 518 名儿童的 AC 在其子女的儿科诊所接受了流感疫苗接种。AC 的平均年龄为 35.9 岁(范围,22-70 岁),其中 68.5%为母亲。大多数接受疫苗接种的 AC(n = 294,99%)拥有私人保险。几乎所有 AC(n = 250,84%)都在孩子就诊当天接种了疫苗。49.6%的 AC 子女患有高危疾病。由于父母的共付额较高(n = 3,1%),因此 Medicaid 儿童的父母代表人数不足。 Medicaid 人群最少的诊所的疫苗接种参与率最高。

结论

AC 愿意在其子女的儿科初级保健办公室接受流感疫苗接种。当 AC 为女性、拥有私人保险、其子女患有慢性病以及疫苗接种在孩子就诊当天提供时,接种疫苗的接受率更高。 Medicaid 保险的 AC 接种率低的可能原因是费用高;因此,工作人员非常清楚 Medicaid 的不报销情况,可能会向这些父母提供较少的疫苗。

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