Nm. Bennett et al., A COORDINATED, COMMUNITY-WIDE PROGRAM IN MONROE COUNTY, NEW-YORK, TO INCREASE INFLUENZA IMMUNIZATION RATES IN THE ELDERLY, Archives of internal medicine, 154(15), 1994, pp. 1741-1745
Background: Despite the efficacy of influenza vaccination in preventin
g complications of influenza, rates of immunization among high-risk po
pulations remain low. The Monroe County (New York) Influenza Vaccinati
on Demonstration was a communitywide, collaborative effort to increase
the rates of influenza immunization to greater than 60% in elderly Me
dicare recipients. Methods: The local health department, university me
dical center, and practicing physicians collaborated to develop a comm
unitywide demonstration directed to all Medicare part B enrollees 65 y
ears of age or older; multiple coordinated approaches were used over a
4-year period (1988 to 1992). Most providers, including public agenci
es, private providers, hospital outpatient facilities, nursing homes,
and insurance providers, were enrolled in a comprehensive program that
included centralized claims processing, vaccine distribution and prom
otion, and extensive provider and public education efforts, including
a special urban outreach program. An office-based, denominator-driven
physician incentive project was also evaluated. Results: The demonstra
tion project resulted in a 1991 influenza immunization rate of 74.3% a
mong 88 811 Medicare enrollees 65 years of age or older. The increase
in immunization rate occurred primarily among the patients of private
physicians. Conclusion: A communitywide, collaborative approach can su
cceed in achieving high rates of influenza immunization.