Influenza and pneumococcal vaccination among Native American elders in a primary care practice

被引:23
作者
Buchwald, D
Sheffield, J
Furman, R
Hartman, S
Dudden, M
Manson, S
机构
[1] Univ Washington, Dept Med, Seattle, WA 98195 USA
[2] Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA
关键词
D O I
10.1001/archinte.160.10.1443
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: More than 2 million Native Americans tie, Native Americans and Native Alaskans) live in the United States; 60% reside in cities. This population, especially its elders, is especially susceptible to respiratory diseases; yet, adherence to guidelines for influenza and pneunococcal immunizations is unknown. Objectives: To evaluate how frequently older acid highrisk adults received vaccinations for influenza and pneumoncoccal infection and to identify patient characteristics associated with adherence to published recommendations. Methods: Retrospective medical record review of 550 Native American elders seen in an urban primary care practice defined using a culturally appropriate age threshold (greater than or equal to 50 years) and standard criteria (greater than or equal to 65 years). Univariate analyses examined demographic and clinical information by vaccination status. Logistic regressions identified factors associated with adherence to immunization guidelines. Results: Among patients aged 50 years and older with any indication according to published recommendations, rates were low for influenza (31%) and pneumococcal (21%) immunizations. Likewise, few subjects at least 65 years of age had been immunized appropriately against influenza (38%) or pneumococcus (32%). Younger age and alcohol use were significantly associated with less frequent immunization; Medicare insurance, depression, and more health problems and taking more medications predicted significantly higher immunization rates. Aged 65 years or older and having cardiovascular disease or diabetes mellitus were specific indications significantly correlated with receipt of influenza and pneumococcal vaccine. Conclusions: Regardless of age or risk, inadequate vaccination rates were observed in elderly Native Americans. Our findings suggest the need to identify obstacles to immunization and to conduct prospective and elderly intervention studies in Native American populations.
引用
收藏
页码:1443 / 1448
页数:6
相关论文
共 37 条
  • [1] *AM ASS RET PEOPL, 1991, HLTH PEOPL 2000 HLTH
  • [2] ANDERSON PA, 1995, J GEN INTERN MED S, V97
  • [3] [Anonymous], 1996, GUID CLIN PREV SERV
  • [4] BUCHWALD D, IN PRESS J GEN MED
  • [5] PROMOTING SCREENING MAMMOGRAPHY IN INNER-CITY SETTINGS - A RANDOMIZED CONTROLLED TRIAL OF COMPUTERIZED REMINDERS AS A COMPONENT OF A PROGRAM TO FACILITATE MAMMOGRAPHY
    BURACK, RC
    GIMOTTY, PA
    GEORGE, J
    STENGLE, W
    WARBASSE, L
    MONCREASE, A
    [J]. MEDICAL CARE, 1994, 32 (06) : 609 - 624
  • [6] Black women receive less mammography even with similar use of primary care
    Burns, RB
    McCarthy, EP
    Freund, KM
    Marwill, SL
    Shwartz, M
    Ash, A
    Moskowitz, MA
    [J]. ANNALS OF INTERNAL MEDICINE, 1996, 125 (03) : 173 - +
  • [7] CUNNINGHAM P, 1991, AHCPR PUBL, P1
  • [8] THE EPIDEMIOLOGY OF INVASIVE PNEUMOCOCCAL DISEASE IN ALASKA, 1986-1990 - ETHNIC-DIFFERENCES AND OPPORTUNITIES FOR PREVENTION
    DAVIDSON, M
    PARKINSON, AJ
    BULKOW, LR
    FITZGERALD, MA
    PETERS, HV
    PARKS, DJ
    [J]. JOURNAL OF INFECTIOUS DISEASES, 1994, 170 (02) : 368 - 376
  • [9] DAVIS T, 1995, J GEN INTERN MED S, V99
  • [10] Fedson D S, 1992, Clin Geriatr Med, V8, P183