To compare influenza vaccination billing rates for patients seen by physiatrists with those of four other specialties : neurology, rheumatology, family practice, and internal medicine.
Retrospective cohort analysis using Medicare billing data.
234,164 Medicare outpatients seen in Washington state between September 1 and December 31,1994.
Based on Medicare's billing data, only 6 of 99 physiatrists ordered vaccinations, and they immunized only 159 (6%) of the patients seen.
An additional 1,109 (42%) patients seen by physiatrists were vaccinated by other physicians.
Physiatric patients were less likely to have been vaccinated than those seen by internists, family practitioners, or rheumatologists (p<. 002), but equally likely as those seen by neurologists (p=07).
A significantly smaller percentage of physiatrists ordered vaccinations than all other specialties (p<. 04).
Utilizing pre-existing survey data, the misclassification rate (those immunized but not billed) was estimated at 22% of our original cohort.
Thus, approximately 800 patients, one third of those seeing physiatrists, may not have been immunized.
We estimated the increase in hospitalization costs to be $117 per nonvaccinated patient (total>$90,000).
Missed opportunities for vaccination by physiatrists appear to be more frequent than in other specialties and have potentially large health and economic costs.
Mots-clés Pascal : Grippe, Virose, Infection, Prévention, Vaccination, Prescription médicale, Médecin généraliste, Physiothérapie, Incidence, Etude comparative, Homme, Appareil respiratoire pathologie, Economie santé
Mots-clés Pascal anglais : Influenza, Viral disease, Infection, Prevention, Vaccination, Medical prescription, General practitioner, Physiotherapy, Incidence, Comparative study, Human, Respiratory disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0295454
Code Inist : 002B30A01C. Création : 27/11/1998.