Influenza vaccine uptake in the elderly population: Individual and general practitioner's determinants in Central Italy, Lazio region, 2016-2017 season

Massimo Fabiani, Enrico Volpe, Maurizio Faraone, Antonino Bella, Caterina Rizzo, Stefano Marchetti, Patrizio Pezzotti, Francesco Chini

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Abstract

BACKGROUND: Elderly people are a priority target group for influenza vaccination and their decision to be vaccinated might partly depend on advice received from general practitioners (GP). This study aims to investigate the association between influenza vaccine uptake in the elderly residents in the Lazio region of Italy and the demographic and professional characteristics of their GPs, taking simultaneously into account the elderly's individual characteristics.

METHODS: We used data retrieved from different administrative sources to retrospectively analyse the cohort of 1,255,657 elderly residents aged ≥65 years who were alive and registered in the regional healthcare service at the beginning of the 2016-2017 influenza vaccination campaign (1 Oct. 2016-31 Jan. 2017). We assessed influenza vaccine uptake at the end of the vaccination campaign and evaluated its association with both individual and GP-related characteristics through a multilevel Poisson regression models accounting for clustering at physician level.

RESULTS: Overall, vaccination coverage at the end of vaccination campaign was 50.6%. Elderly residents who were male, older, vaccinated in the previous seasons, living in smaller provinces, and spending more money for specialist medical care showed a significantly increased probability to be vaccinated. Vaccine uptake was also significantly higher in the elderly residents assisted by GPs who got master's degree more recently, assisted a relatively high proportion of elderly patients, received influenza vaccination, had a computer assistant, and were associated with other physicians.

CONCLUSIONS: Our results indicate that influenza vaccination coverage in the elderly residents of the Lazio region is still unsatisfactorily low. We identified several determinants of influenza vaccine uptake, related to both individual and GP characteristics. Understanding how GP characteristics affected influenza vaccine uptake in the elderly population might provide insight on GPs' attitudes and concerns regarding influenza vaccination, allowing the implementation of targeted evidence-based interventions to sensitise GPs and increase vaccination coverage.

Original languageEnglish
Pages (from-to)5314-5322
Number of pages9
JournalVaccine
Volume37
Issue number36
DOIs
Publication statusPublished - Aug 23 2019

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Influenza Vaccines
influenza
General Practitioners
Italy
vaccination
vaccines
Vaccination
Human Influenza
Population
Immunization Programs
physicians
Physicians
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Cluster Analysis
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Vaccines
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Influenza vaccine uptake in the elderly population : Individual and general practitioner's determinants in Central Italy, Lazio region, 2016-2017 season. / Fabiani, Massimo; Volpe, Enrico; Faraone, Maurizio; Bella, Antonino; Rizzo, Caterina; Marchetti, Stefano; Pezzotti, Patrizio; Chini, Francesco.

In: Vaccine, Vol. 37, No. 36, 23.08.2019, p. 5314-5322.

Research output: Contribution to journalArticle

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title = "Influenza vaccine uptake in the elderly population: Individual and general practitioner's determinants in Central Italy, Lazio region, 2016-2017 season",
abstract = "BACKGROUND: Elderly people are a priority target group for influenza vaccination and their decision to be vaccinated might partly depend on advice received from general practitioners (GP). This study aims to investigate the association between influenza vaccine uptake in the elderly residents in the Lazio region of Italy and the demographic and professional characteristics of their GPs, taking simultaneously into account the elderly's individual characteristics.METHODS: We used data retrieved from different administrative sources to retrospectively analyse the cohort of 1,255,657 elderly residents aged ≥65 years who were alive and registered in the regional healthcare service at the beginning of the 2016-2017 influenza vaccination campaign (1 Oct. 2016-31 Jan. 2017). We assessed influenza vaccine uptake at the end of the vaccination campaign and evaluated its association with both individual and GP-related characteristics through a multilevel Poisson regression models accounting for clustering at physician level.RESULTS: Overall, vaccination coverage at the end of vaccination campaign was 50.6{\%}. Elderly residents who were male, older, vaccinated in the previous seasons, living in smaller provinces, and spending more money for specialist medical care showed a significantly increased probability to be vaccinated. Vaccine uptake was also significantly higher in the elderly residents assisted by GPs who got master's degree more recently, assisted a relatively high proportion of elderly patients, received influenza vaccination, had a computer assistant, and were associated with other physicians.CONCLUSIONS: Our results indicate that influenza vaccination coverage in the elderly residents of the Lazio region is still unsatisfactorily low. We identified several determinants of influenza vaccine uptake, related to both individual and GP characteristics. Understanding how GP characteristics affected influenza vaccine uptake in the elderly population might provide insight on GPs' attitudes and concerns regarding influenza vaccination, allowing the implementation of targeted evidence-based interventions to sensitise GPs and increase vaccination coverage.",
author = "Massimo Fabiani and Enrico Volpe and Maurizio Faraone and Antonino Bella and Caterina Rizzo and Stefano Marchetti and Patrizio Pezzotti and Francesco Chini",
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T1 - Influenza vaccine uptake in the elderly population

T2 - Individual and general practitioner's determinants in Central Italy, Lazio region, 2016-2017 season

AU - Fabiani, Massimo

AU - Volpe, Enrico

AU - Faraone, Maurizio

AU - Bella, Antonino

AU - Rizzo, Caterina

AU - Marchetti, Stefano

AU - Pezzotti, Patrizio

AU - Chini, Francesco

N1 - Copyright © 2019 Elsevier Ltd. All rights reserved.

PY - 2019/8/23

Y1 - 2019/8/23

N2 - BACKGROUND: Elderly people are a priority target group for influenza vaccination and their decision to be vaccinated might partly depend on advice received from general practitioners (GP). This study aims to investigate the association between influenza vaccine uptake in the elderly residents in the Lazio region of Italy and the demographic and professional characteristics of their GPs, taking simultaneously into account the elderly's individual characteristics.METHODS: We used data retrieved from different administrative sources to retrospectively analyse the cohort of 1,255,657 elderly residents aged ≥65 years who were alive and registered in the regional healthcare service at the beginning of the 2016-2017 influenza vaccination campaign (1 Oct. 2016-31 Jan. 2017). We assessed influenza vaccine uptake at the end of the vaccination campaign and evaluated its association with both individual and GP-related characteristics through a multilevel Poisson regression models accounting for clustering at physician level.RESULTS: Overall, vaccination coverage at the end of vaccination campaign was 50.6%. Elderly residents who were male, older, vaccinated in the previous seasons, living in smaller provinces, and spending more money for specialist medical care showed a significantly increased probability to be vaccinated. Vaccine uptake was also significantly higher in the elderly residents assisted by GPs who got master's degree more recently, assisted a relatively high proportion of elderly patients, received influenza vaccination, had a computer assistant, and were associated with other physicians.CONCLUSIONS: Our results indicate that influenza vaccination coverage in the elderly residents of the Lazio region is still unsatisfactorily low. We identified several determinants of influenza vaccine uptake, related to both individual and GP characteristics. Understanding how GP characteristics affected influenza vaccine uptake in the elderly population might provide insight on GPs' attitudes and concerns regarding influenza vaccination, allowing the implementation of targeted evidence-based interventions to sensitise GPs and increase vaccination coverage.

AB - BACKGROUND: Elderly people are a priority target group for influenza vaccination and their decision to be vaccinated might partly depend on advice received from general practitioners (GP). This study aims to investigate the association between influenza vaccine uptake in the elderly residents in the Lazio region of Italy and the demographic and professional characteristics of their GPs, taking simultaneously into account the elderly's individual characteristics.METHODS: We used data retrieved from different administrative sources to retrospectively analyse the cohort of 1,255,657 elderly residents aged ≥65 years who were alive and registered in the regional healthcare service at the beginning of the 2016-2017 influenza vaccination campaign (1 Oct. 2016-31 Jan. 2017). We assessed influenza vaccine uptake at the end of the vaccination campaign and evaluated its association with both individual and GP-related characteristics through a multilevel Poisson regression models accounting for clustering at physician level.RESULTS: Overall, vaccination coverage at the end of vaccination campaign was 50.6%. Elderly residents who were male, older, vaccinated in the previous seasons, living in smaller provinces, and spending more money for specialist medical care showed a significantly increased probability to be vaccinated. Vaccine uptake was also significantly higher in the elderly residents assisted by GPs who got master's degree more recently, assisted a relatively high proportion of elderly patients, received influenza vaccination, had a computer assistant, and were associated with other physicians.CONCLUSIONS: Our results indicate that influenza vaccination coverage in the elderly residents of the Lazio region is still unsatisfactorily low. We identified several determinants of influenza vaccine uptake, related to both individual and GP characteristics. Understanding how GP characteristics affected influenza vaccine uptake in the elderly population might provide insight on GPs' attitudes and concerns regarding influenza vaccination, allowing the implementation of targeted evidence-based interventions to sensitise GPs and increase vaccination coverage.

U2 - 10.1016/j.vaccine.2019.07.054

DO - 10.1016/j.vaccine.2019.07.054

M3 - Article

C2 - 31331778

VL - 37

SP - 5314

EP - 5322

JO - Vaccine

JF - Vaccine

SN - 0264-410X

IS - 36

ER -