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Darmaputra DC, Zaman FY, Khu YL, Nagalingam V, Liew D, Aung AK. Cost-analysis of opportunistic influenza vaccination in general medical inpatients. Intern Med J 2021; 51:591-595. [PMID: 33890379 DOI: 10.1111/imj.15270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 11/30/2022]
Abstract
Influenza vaccination is an important preventative health measure in the elderly and those with medical comorbidities. It has been shown to reduce hospitalisations, cardiovascular and respiratory complications. A significant proportion of patients admitted to general medicine are eligible for opportunistic inpatient influenza vaccination. This study explores the cost-effectiveness of such a strategy in reducing subsequent healthcare utilisation costs.
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Affiliation(s)
- Daniel C Darmaputra
- Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Farzana Y Zaman
- Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Yin Li Khu
- Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Vathy Nagalingam
- Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Ar Kar Aung
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
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Zaman FY, Nagalingam V, Wong C, Khu YL, Teng HWG, Janardan J, Ritchie E, Cheng AC, Aung AK. Opportunities to improve influenza vaccination rates in general medical inpatients. Intern Med J 2020; 49:662-665. [PMID: 31083800 DOI: 10.1111/imj.14275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/25/2018] [Accepted: 10/07/2018] [Indexed: 12/01/2022]
Abstract
Influenza vaccination is an important preventative health measure. A significant proportion of general medical inpatients meets indications for annual inactivated influenza vaccination (IIV), as recommended by the Australian National Immunisation Programme. This study explores opportunities to provide IIV to eligible general medical inpatients and associated barriers.
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Affiliation(s)
- Farzana Y Zaman
- Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Vathy Nagalingam
- Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Chloe Wong
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Yin Li Khu
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Hui Wen G Teng
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jyotsna Janardan
- Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Edward Ritchie
- Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Allen C Cheng
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Ar Kar Aung
- Department of General Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.,School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia
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Abstract
Human papillomavirus vaccination (HPV) remains low in the United States. The inpatient postpartum setting provides an innovative opportunity to vaccinate eligible patients. This study evaluated two different interventions to improve HPV vaccination rates in hospitalized postpartum patients: a nurse based protocol and an electronic medical record (EMR) postpartum order prompt. This was a comparative intervention study performed in a prospective cohort of postpartum patients at two affiliated County Hospitals. The intervention was conducted over a 6-month period aimed at increasing HPV vaccination rates through a nurse based protocol at one hospital (H-NBP) and an EMR postpartum order prompt at the second hospital (H-EMR). Outcomes measures included vaccine administration, patient refusal, and vaccine wastage. A multiple logistic regression model was used to compare outcomes. At H-NBP, 143 vaccine-eligible patients (74%) were identified of which 44 (32%) received the HPV vaccine, 66 (46%) refused, and 33 (21%) had missed opportunities. At H-EMR, 169 patients (87%) were identified as vaccine-eligible of which 111 (66%) received the HPV4 vaccine, 24 (14%) refused and 34 (20%) had missed opportunities. After adjusting for sociodemographic variables, patients at H-EMR were nearly 6 times more likely than patients at H-NBP to undergo postpartum HPV vaccination (OR 5.865, CI 3.358-10.245, p value < 0.0001). An EMR prompt offers a greater impact on HPV vaccination rates than a nursing protocol. The feasibility and success of inpatient postpartum HPV vaccination interventions as demonstrated in this study provides insights on how to approach vaccination strategies in nontraditional clinical settings.
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