Makoto Kaneko1,2,3, Takuya Aoki4,5, Ryohei Goto6, Sachiko Ozone6, Junji Haruta6,7. 1. Department of Family and Community Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan. kanekom@yokohama-cu.ac.jp. 2. Shizuoka Family Medicine Program, Shizuoka, Japan. kanekom@yokohama-cu.ac.jp. 3. Primary Care Research Unit, Graduate School of Health Data Science, Yokohama City University, Yokohama, Kanagawa, Japan. kanekom@yokohama-cu.ac.jp. 4. Division of Clinical Epidemiology, Jikei University School of Medicine, Tokyo, Japan. 5. Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 6. Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. 7. Medical Education Center, School of Medicine, Keio University, Tokyo, Japan.
Abstract
BACKGROUND: Older adults' uptake of influenza and pneumococcus vaccines is insufficient worldwide. Although patient experience of primary care is associated with vaccine uptake in children, this relationship remains unclear for older adults. OBJECTIVE: This study examined the association between patient experience of primary care and influenza/pneumococcal vaccine uptake in older adults. DESIGN AND METHODS: We conducted a multicentered cross-sectional survey involving 25 primary care institutions in urban and rural areas in Japan. Participants were outpatients aged ≥ 65 years who visited one of the participating institutions within the 1-week study period. We assessed patient experience of primary care using the Japanese version of the Primary Care Assessment Tool (JPCAT), which includes six domains: first contact (accessibility), longitudinality (continuity of care), coordination, comprehensiveness (services available), comprehensiveness (services provided), and community orientation. We used a generalized linear mixed-effects model to adjust for clustering within institutions and individual covariates. KEY RESULTS: One thousand participants were included in the analysis. After adjusting for clustering within institutions and other possible confounders, influenza and pneumococcal vaccine uptake was positively associated with JPCAT total scores (odds ratio per 1 standard deviation increase: 1.19, 95% confidence interval: 1.01-1.40 and odds ratio: 1.26, 95% confidence interval: 1.08-1.46, respectively). Of the JPCAT domains, coordination and community orientation were associated with influenza vaccine uptake and longitudinality, coordination, and comprehensiveness were associated with pneumococcal vaccine uptake. CONCLUSIONS: Influenza and pneumococcal vaccine uptake were positively associated with patient experience of primary care in older adults. Consideration of patient experience, particularly longitudinality, coordination, comprehensiveness, and community orientation, could improve vaccine uptake.
BACKGROUND: Older adults' uptake of influenza and pneumococcus vaccines is insufficient worldwide. Although patient experience of primary care is associated with vaccine uptake in children, this relationship remains unclear for older adults. OBJECTIVE: This study examined the association between patient experience of primary care and influenza/pneumococcal vaccine uptake in older adults. DESIGN AND METHODS: We conducted a multicentered cross-sectional survey involving 25 primary care institutions in urban and rural areas in Japan. Participants were outpatients aged ≥ 65 years who visited one of the participating institutions within the 1-week study period. We assessed patient experience of primary care using the Japanese version of the Primary Care Assessment Tool (JPCAT), which includes six domains: first contact (accessibility), longitudinality (continuity of care), coordination, comprehensiveness (services available), comprehensiveness (services provided), and community orientation. We used a generalized linear mixed-effects model to adjust for clustering within institutions and individual covariates. KEY RESULTS: One thousand participants were included in the analysis. After adjusting for clustering within institutions and other possible confounders, influenza and pneumococcal vaccine uptake was positively associated with JPCAT total scores (odds ratio per 1 standard deviation increase: 1.19, 95% confidence interval: 1.01-1.40 and odds ratio: 1.26, 95% confidence interval: 1.08-1.46, respectively). Of the JPCAT domains, coordination and community orientation were associated with influenza vaccine uptake and longitudinality, coordination, and comprehensiveness were associated with pneumococcal vaccine uptake. CONCLUSIONS: Influenza and pneumococcal vaccine uptake were positively associated with patient experience of primary care in older adults. Consideration of patient experience, particularly longitudinality, coordination, comprehensiveness, and community orientation, could improve vaccine uptake.
Authors: Rebecca Anhang Price; Marc N Elliott; Alan M Zaslavsky; Ron D Hays; William G Lehrman; Lise Rybowski; Susan Edgman-Levitan; Paul D Cleary Journal: Med Care Res Rev Date: 2014-07-15 Impact factor: 3.929
Authors: Michael V Maciosek; Amy B LaFrance; Steven P Dehmer; Dana A McGree; Thomas J Flottemesch; Zack Xu; Leif I Solberg Journal: Ann Fam Med Date: 2017-01-06 Impact factor: 5.166