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Association Between Number of Physician Visits and Influenza Vaccination Coverage Among Diabetic Adults With Access to Care

From the Department of Medicine, Medical University of South Carolina, Charleston, South Carolina

Address correspondence and reprint requests to Leonard E. Egede, MD, MS, Medical University of South Carolina, Division of General Internal Medicine and Geriatrics, McClennan-Banks Adult Primary Care Clinic (4th Floor), 326 Calhoun St., PO Box 250100, Charleston, SC 29401. E-mail: egedel{at}musc.edu

OBJECTIVE—The proportion of diabetic adults that receives the influenza vaccine is less than ideal. This study determined the relationship between the number of physician visits in the previous 12 months and the likelihood of influenza vaccination among diabetic adults with access to care.

RESEARCH DESIGN AND METHODS—Data on 1,807 diabetic adults with access to care in the 1999 National Health Interview Survey (NHIS) were analyzed. Prevalence of influenza vaccination was determined by number of physician visits. Logistic regression was used to determine the independent association between number of physician visits and influenza vaccination coverage, controlling for age, sex, race/ethnicity, education, income, employment census region, and comorbidity. STATA was used for analyses to account for the complex sampling design of NHIS.

RESULTS—Overall, 56% of subjects received the influenza vaccine. Proportions vaccinated by number of physician visits were as follows: 35% (no visit), 47% (1–3 visits), 58% (4–9 visits), and 61% (10 visits). Compared with people with no physician visit, people with 4–9 visits (odds ratio [OR] 2.61) and 10 visits (2.96) were significantly more likely to be vaccinated. However, after controlling for covariates, only people with 10 visits (2.34) were significantly more likely to be vaccinated.

CONCLUSIONS—In this nationally representative sample, repeated physician visits by diabetic adults with access to care were associated with only modest increases in influenza vaccination coverage. In adjusted analysis, odds of influenza vaccination were not significantly associated with number of physician visits, except in people with 10 visits.

Abbreviations: ACIP, Advisory Committee on Immunization Practices • ADA, American Diabetes Association • NHIS, National Health Interview Survey

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