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瑞士高危患者的流感疫苗接种率-国家索赔数据在监测中的潜力。

Influenza vaccination uptake among at-risk patients in Switzerland-The potential of national claims data for surveillance.

机构信息

Institute of Primary Care University of Zurich and University Hospital Zurich Zurich Switzerland.

Groupe Mutuel Martigny Switzerland.

出版信息

Influenza Other Respir Viruses. 2023 Oct 13;17(10):e13206. doi: 10.1111/irv.13206. eCollection 2023 Oct.

Abstract

BACKGROUND

Swiss national surveillance of influenza vaccination uptake rates (VURs) relies on self-reported vaccination status. The aim of this study was to determine VURs among at-risk patients, namely, patients ≥65 of age and adult patients with chronic diseases, using claims data, instead of self-reported measures, to investigate factors of vaccine uptake, and to assess different methodological approaches to conduct vaccination surveillance.

METHODS

In this retrospective cross-sectional analysis, we determined VURs in three influenza seasons (2015/2016-2017/2018). Medication, diagnosis, or medical services claims were used as triggers to identify patients. For the calculation of VURs in patients with chronic diseases, we identified those by triggers in the given season only (Model 1) and in the given and previous seasons (Model 2). Regression analysis was used to identify factors associated with vaccination status.

RESULTS

Data from 214,668 individual patients were analyzed. VURs over all seasons ranged from 18.4% to 19.8%. Most patients with chronic diseases were identified with the medication trigger, and we found no clinical significant differences in VURs comparing both models. Having a chronic disease, age, male gender, and regular health care provider visits were associated with increased odds of being vaccinated.

CONCLUSIONS

VURs were below the recommended thresholds, and our analysis highlighted the need for efforts to increase VURs. We assessed the identification of chronic diseases by medication claims and the calculation of VURs based on data of the given season only as an effective approach to conduct vaccination surveillance. Claims data-based surveillance may complete the national surveillance.

摘要

背景

瑞士的全国流感疫苗接种率(VUR)监测依赖于自我报告的疫苗接种状况。本研究旨在使用索赔数据(而非自我报告措施)确定高危患者(即≥65 岁的患者和患有慢性病的成年患者)的 VUR,以调查疫苗接种的影响因素,并评估不同的方法来进行疫苗接种监测。

方法

在这项回顾性横断面分析中,我们在三个流感季节(2015/2016-2017/2018 年)确定了 VUR。使用药物、诊断或医疗服务的理赔作为触发因素来识别患者。为了计算慢性病患者的 VUR,我们仅在给定季节(模型 1)和给定季节及前一个季节(模型 2)中使用触发因素来识别这些患者。回归分析用于确定与疫苗接种状况相关的因素。

结果

分析了 214668 名患者的数据。所有季节的 VUR 范围在 18.4%至 19.8%之间。大多数患有慢性病的患者通过药物触发因素被识别出来,我们发现两种模型的 VUR 之间没有临床显著差异。患有慢性病、年龄、男性和定期看医生与增加接种疫苗的几率相关。

结论

VUR 低于推荐阈值,我们的分析强调需要努力提高 VUR。我们评估了使用药物理赔来识别慢性病的方法和仅基于当年数据计算 VUR 的方法,认为这是进行疫苗接种监测的有效方法。基于理赔数据的监测可能会补充全国性监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba2/10570900/48f71110e362/IRV-17-e13206-g001.jpg

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