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A Coordinated, Communitywide Program in Monroe County, New York, to Increase Influenza Immunization Rates in the Elderly
Nancy M. Bennett, MD, MS;
Bonnie Lewis;
Andrew S. Doniger, MD, MPH;
Karen Bell, MD;
Ruth Kouides, MD;
F. Marc LaForce, MD;
William Barker, MD
Arch Intern Med. 1994;154(15):1741-1745.
Abstract
Background
Despite the efficacy of influenza vaccination in preventing complications of influenza, rates of immunization among high-risk populations remain low. The Monroe County (New York) Influenza Vaccination Demonstration was a communitywide, collaborative effort to increase the rates of influenza immunization to greater than 60% in elderly Medicare recipients.
Methods
The local health department, university medical center, and practicing physicians collaborated to develop a communitywide demonstration directed to all Medicare part B enrollees 65 years of age or older; multiple coordinated approaches were used over a 4-year period (1988 to 1992). Most providers, including public agencies, private providers, hospital outpatient facilities, nursing homes, and insurance providers, were enrolled in a comprehensive program that included centralized claims processing, vaccine distribution and promotion, and extensive provider and public education efforts, including a special urban outreach program. An office-based, denominator-driven physician incentive project was also evaluated.
Results
The demonstration project resulted in a 1991 influenza immunization rate of 74.3% among 88 811 Medicare enrollees 65 years of age or older. The increase in immunization rate occurred primarily among the patients of private physicians.
Conclusion
A communitywide, collaborative approach can succeed in achieving high rates of influenza immunization.
(Arch Intern Med. 1994;154:1741-1745)
Author Affiliations
From the Monroe County (New York) Health Department (Drs Bennett, Doniger, and Bell and Ms Lewis) and the Departments of Medicine (Drs Bennett, Kouides, and LaForce) and Community and Preventive Medicine (Drs Bennett, Kouides, and Barker), University of Rochester (NY) School of Medicine. Dr Bell is now with the Harvard Community Health Plan, Boston, Mass.
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