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Related Experiment Videos

Failure to immunize the elderly: a systems problem or a statement of personal values?

J B Fowles1, T J Beebe

  • 1Health Research Center, Institute for Research and Education, HealthSystem Minnesota, Minneapolis 55416, USA. fowlej@hsmnet.com

The Joint Commission Journal on Quality Improvement
|December 30, 1998
PubMed
Summary

Most elderly individuals do not get annual influenza immunizations. Health care system characteristics and personal values significantly influence elderly influenza immunization status, with better systems increasing rates.

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Area of Science:

  • Gerontology
  • Public Health
  • Health Services Research

Background:

  • Influenza vaccination is proven to reduce pneumonia, hospitalization, and death in the elderly.
  • Despite proven benefits, most seniors do not receive annual influenza immunizations.
  • This study investigated factors influencing influenza immunization status in older adults.

Purpose of the Study:

  • To examine the impact of healthcare delivery system characteristics on influenza immunization rates among seniors.
  • To assess the role of individual personal values in elderly influenza immunization decisions.

Main Methods:

  • Secondary data analysis of a mailed survey.
  • Survey included 3,362 seniors aged 65+ enrolled in a Minnesota Health Maintenance Organization.

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  • Analysis controlled for known variables affecting immunization likelihood.

    • Main Results:

    • The study population's immunization rate (77.1%) exceeded the state average (64%).
    • Healthcare system characteristics and personal values were significantly associated with immunization status.
    • Seniors in systems with robust immunization programs were more likely to be vaccinated.
    • Avoidance of physician visits and risky behaviors like smoking were linked to lower immunization rates.

    Conclusions:

    • Managed care organizations can improve influenza immunization rates in the elderly by addressing system-level barriers.
    • System improvements can reduce barriers such as cost and access to vaccines.
    • Achieving optimal influenza immunization requires addressing both individual values and systemic solutions.