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Outpatient care intensity and influenza vaccination: evidence from Germany
D Gensorowsky1, B Surmann1, A C Meyer2
1Vandage GmbH, Bielefeld, Germany.
Background:
Despite recommendations from German public health authorities for seasonal influenza immunization, vaccination coverage rates (VCRs) fall short of targets. This study explores gaps in influenza VCRs, focusing on the intensity of outpatient care of adults for whom vaccination is recommended.
Material And Methods:
We conducted a retrospective study based on a large German statutory health insurance claims database provided by GWQ ServicePlus AG. For influenza seasons 2016-2017 to 2022-2023, we examined seasonal VCRs in the adult population differentiated by age, prevalence of chronic conditions, and participation in disease management programs (DMP) or GP-centered care programs. We also explored the relationship between VCRs and physician contact frequency during the vaccination-relevant period from September to February.
Results:
Seasonal VCRs of individuals aged 60+, for whom influenza vaccination is generally recommended, varied between 34.8 % (2016-2017) and 47.0 % (2020-2021). We observed higher VCRs among individuals with chronic conditions and among individuals who participated in GP-centered care in all age groups. Among adults with DMP-relevant chronic conditions, VCRs were higher for participants than for individuals not participating in 4 out of 5 examined DMPs. VCRs consistently increased with number of GP contacts. In the 60+ group, cross-seasonal average VCRs increased from 24.0 % for individuals with one GP contact to 52.7 % for individuals with five or more GP contacts. However, most unvaccinated individuals with chronic conditions in this age group had 5 or more GP contacts during the vaccination-relevant period.
Conclusion:
VCRs remain below targets for all investigated groups. Higher VCRs among DMP and GP-centered care participants and patients with multiple GP contacts emphasize the relevance of outpatient care intensity for the vaccination process. However, most unvaccinated individuals with prevalent chronic conditions have frequent contacts with care providers, underlining the need for care providers to routinely assess and discuss the vaccination status of their patients.
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