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  1. Influenza vaccinations of Washington State Medicare beneficiaries seen by physiatrists in the outpatient setting in 1994.

    Article - En anglais

    Objective 

    To compare influenza vaccination billing rates for patients seen by physiatrists with those of four other specialties : neurology, rheumatology, family practice, and internal medicine.

    Design 

    Retrospective cohort analysis using Medicare billing data.

    Patients 

    234,164 Medicare outpatients seen in Washington state between September 1 and December 31,1994.

    Results 

    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).

    Conclusions 

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0295454

    Code Inist : 002B30A01C. Création : 27/11/1998.