Oregon Health & Science University, Portland, OR, USA.
Yale School of Medicine, New Haven, CT, USA.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720962870. doi: 10.1177/2150132720962870.
Investigate whether combinations of sociodemographic factors, chronic conditions, and other health indicators pose barriers for older adults to access Annual Wellness Visits (AWVs) and influenza vaccinations.
Data on 4999 individuals aged ≥65 years from the 2012 wave of the Health and Retirement Study linked with Medicare claims were analyzed. Conditional Inference Tree (CIT) and Random Forest (CIRF) analyses identified the most important predictors of AWVs and influenza vaccinations. Multivariable logistic regression (MLR) was used to quantify the associations.
Two-year uptake was 22.8% for AWVs and 65.9% for influenza vaccinations. For AWVs, geographical region and wealth emerged as the most important predictors. For influenza vaccinations, number of somatic conditions, race/ethnicity, education, and wealth were the most important predictors.
The importance of geographic region for AWV utilization suggests that this service was unequally adopted. Non-Hispanic black participants and/or those with functional limitations were less likely to receive influenza vaccination.
研究社会人口因素、慢性疾病和其他健康指标的组合是否会给老年人带来障碍,使其无法获得年度健康访视(AWV)和流感疫苗接种。
对来自健康与退休研究(Health and Retirement Study)2012 年波次的 4999 名年龄≥65 岁的个人数据与医疗保险索赔进行了分析。条件推理树(CIT)和随机森林(CIRF)分析确定了 AWV 和流感疫苗接种的最重要预测因素。多变量逻辑回归(MLR)用于量化关联。
AWV 的两年接种率为 22.8%,流感疫苗接种率为 65.9%。对于 AWV,地理区域和财富是最重要的预测因素。对于流感疫苗接种,躯体疾病数量、种族/族裔、教育和财富是最重要的预测因素。
地理区域对 AWV 利用率的重要性表明,该服务的采用不平等。非西班牙裔黑人参与者和/或有功能障碍的参与者不太可能接种流感疫苗。