Abstract
Objetivo
Identificar las características de los médicos y cupos relacionadas con la tasa de vacunación antigripal (VAG) en ancianos y cuantificar la VAG
Diseño
Observacional, transversal, multicéntrico, de ámbito poblacional, utilizando datos primarios
Participantes
Todos los centros del área con registro informatizado de VAG, con un total de 19.457 vacunados (campaña 2001–2002) de 73 médicos que permanecieron en su puesto durante los 2 años previos
Emplazamiento
Atención primaria del Área 19
Mediciones principales
Edad y sexo del médico, titulación MIR, acreditación docente, plaza en propiedad, antigüedad en la plaza, años de ejercicio profesional, modelo asistencial, población total asignada, población y porcentaje de población > 65 años asignada, tasa de VAG del total de asignados. El criterio de evaluación fue la tasa de VAG a ancianos. Realizamos un análisis descriptivo, bivariante, y utilizamos un modelo multivariante, fijando la significación estadística en p < 0,05 y calculando los intevalos de confianza del 95%
Resultados
La tasa de VAG en ancianos (>65 años) fue del 50,9%, con una gran variabilidad entre médicos (del 18 al 77%). La tasa de VAG era menor cuanto mayor era la antigüedad del médico (p = 0,01), la población asignada (p = 0,03), los ancianos asignados (p = 0,000) y el porcentaje de ancianos asignados (p = 0,001), y cuanto menor era la tasa de VAG al total de asignados (p = 0,000), sin que se obtuviera significación con el resto de las variables estudiadas. En el análisis multivariante sólo fue significativo el porcentaje de ancianos asignado
Conclusiones
La tasa de VAG en ancianos es baja, similar a la del entorno. El porcentaje de ancianos asignado es la única variable explicativa del modelo, con una relación inversamente proporcional
Palabras clave: Vacunación antigripal, Ancianos, Factores influyentes
Abstract
Objective
To identify the characteristics of physicians and the patients on their list related with rates of influenza vaccination in older people, and to quantify influenza vaccination coverage in this population group
Design
Observational, cross-sectional, multicenter population-based study with primary data
Participants
All health centers in the health care area that used computerized registries of influenza vaccinations. Vaccination records were analyzed for 73 physicians who had been at their present post for at least 2 years prior to the study, and for 19 457 older people who were vaccinated during the 2001–2002 vaccination campaign
Setting
Primary health care area number 19
Main measures
Physician's age and sex, whether the physician was certified as a specialist in family and community medicine, teaching accreditation, permanent or temporary post, length of time in present post, years of professional practice, type of health center administration, total number of patients in the physician's list, population and percentage of the population >65 years old in the physician's list, influenza vaccination rate referred to the total number of patients on the physician's list. The criterion evaluated was the influenza vaccination rate in older people. Descriptive analysis, bivariate analysis and multivariate analysis were used. A P value <.05 was considered statistically significant, and 95% confidence intervals were calculated
Results
The overall influenza vaccination rate in older people (>65 years) was 50.9%, with considerable variability between physicians (from 18% to 77%). Vaccination rates were lowest in physicians who had been in their current post forlonger (P=.001), with larger patient lists (P=.03), with more older people in their list (P=.000), and with larger proportions of older people in theirlist (P=.001). Lower rates of vaccination in older people were also associated with lower proportions of all patients on the list being vaccinated (P=.000). No significant associations were found for any of the other variables. After multivariate analysis only the percentage of older people on the physician's list remained significantly associated with vaccination rate.Conclusions. Influenza vaccination rates for older people were low and similar to rates reported earlier for this region of Spain. The percentage of older people in the list was the only explanatory variable in the model, and was inversely proportional to vaccination coverage
Key words: Influenza vaccination, Older people, Influencing factors
Este trabajo es parte de una tesis doctoral presentada en la Universidad Miguel Hernández de San Juan. Alicante en septiembre de 2003
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