Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
BMC Health Serv Res. 2021 Mar 4;21(1):197. doi: 10.1186/s12913-021-06177-x.
The World Health Organization recommends vaccination rates of 75% against seasonal influenza for patients over 65 years old. In the 2013/2014 season, the German vaccination rates ranged between 14 and 65%. This study aimed to compare the attitudes, personal characteristics and vaccination behaviours of general practitioners (GPs) in regions with high and low vaccination rates in Germany.
In May 2016, a questionnaire was sent to 1594 GPs practising in 16 districts with the highest and the lowest vaccination rates in Western and Eastern Germany as described by the Central Research Institute of Ambulatory Health Care in Germany for the 2013/2014 season. Descriptive statistics and multiple regression analyses were computed to identify potential factors associated with high vaccination rates.
A total response rate of 32% (515/1594 participants) was observed in the study. GPs reported their attitudes towards vaccination in general and vaccination against influenza as mostly 'very positive' (80%, n = 352 and 65%, n = 288, respectively). GPs practising in regions with low vaccination rates reported their attitudes towards vaccinations in general (p = 0.004) and towards influenza vaccination (p = 0.001) more negatively than their colleagues from regions with high vaccination rates. Multiple logistic regression identified an increasing influence of year-dependent changing efficiency on GPs' influenza rates as the strongest factor for predicting GPs from highly vaccinating regions (OR = 4.31 [1.12-16.60]), followed by the patient's vaccination refusal despite GP advice due to already receiving a vaccination from another physician (OR = 3.20 [1.89-5.43]) and vaccination information gathering through medical colleagues (OR = 2.26 [1.19-4.29]).
The results of this study suggest a correlation between GPs' attitudes and regional vaccination rates. Beneath GPs' individual attitudes, the regional attitude patterns of patients, colleagues and medical assistants surrounding those GPs seem decisive and should be integrated into future campaigns to increase vaccination rates at a regional level.
世界卫生组织建议 65 岁以上患者接种季节性流感疫苗的比例达到 75%。在 2013/2014 赛季，德国的疫苗接种率在 14%至 65%之间。本研究旨在比较德国高接种率和低接种率地区的全科医生（GP）的态度、个人特征和接种行为。
2016 年 5 月，向德国中央门诊保健研究所（Central Research Institute of Ambulatory Health Care in Germany）描述的德国西部地区和东部地区接种率最高和最低的 16 个区的 1594 名 GP 发送了一份调查问卷。描述性统计和多元回归分析用于确定与高接种率相关的潜在因素。
该研究观察到总应答率为 32%（515/1594 名参与者）。GP 报告他们对一般疫苗接种和流感疫苗接种的态度大多为“非常积极”（分别为 80%，n=352 和 65%，n=288）。接种率较低地区的 GP 报告他们对一般疫苗接种（p=0.004）和流感疫苗接种（p=0.001）的态度比接种率较高地区的同事更为消极。多元逻辑回归确定了 GP 流感接种率的年效变化效率的影响逐渐增加是预测高接种率地区 GP 的最强因素（OR=4.31[1.12-16.60]），其次是患者尽管 GP 建议但因已从另一位医生处接种疫苗而拒绝接种（OR=3.20[1.89-5.43]），以及通过医疗同事收集疫苗接种信息（OR=2.26[1.19-4.29]）。
本研究结果表明 GP 态度和区域接种率之间存在相关性。在 GP 个人态度之外，围绕这些 GP 的患者、同事和医疗助理的区域态度模式似乎是决定性的，应将其纳入未来提高区域接种率的活动中。
