Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #121471

Kecia A. Leatherwood, MS¹, Adrienne D. Mims, MD, MPH¹, Carla A. Winston, PhD, MA², and Michael Blue, MHSA³. (1) Prevention and Health Promotion, Kaiser Permanente, 3495 Piedmont Road, NE, Building 9, Atlanta, GA 30305, 404-364-4701, kecia.leatherwood@kp.org, (2) Health Services Research and Evaluation Branch, Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-52, Atlanta, GA 30333, (3) Clinical Outcomes Measurement, Kaiser Permanente, 3495 Piedmont Road, NE, Building 9, Atlanta, GA 30305

Background: Pneumococcal immunization is safe and effective at preventing hospitalizations from pneumococcal disease, which cost an estimated $5000 per admission. However, not all eligible members in a managed care program receive the vaccine as recommended by practice guidelines. Objective: Evaluation of a randomized trial within a managed care setting to determine whether telephone outreach improves pneumococcal vaccination rate. Methods: A total of 2,395 members over age 64 without a co-morbid condition and 3,711 members age 18 and older with diabetes, coronary artery disease or congestive heart failure, were randomized to be in the study. Patients in the intervention arm were sent an advance letter outlining the study. Outreach nurses reminded patients about the study letter, explained the study, and asked permission to discuss the vaccination. Tailored advice responding to their reason(s) for current non-vaccination status was given. Participants were informed that the vaccination was free, available at a nurse visit and scheduled for an appointment if desired. Up to four calls were made. A six month follow-up compared the two groups on vaccination status and determined intervention cost. Results: Patients who received the telephone intervention were 2.3 times more likely to be vaccinated than control group patients (489 in intervention, or 16.1%, vs. 211 in control, or 6.9%; p<0.001). Cost of nurse phone calls was $41,520.50, yielding $149.35 per additional member vaccinated compared to the control group. Conclusions: Utilization of nurses for calls is a cost-effective method to increase the immunization rate and decrease hospital costs for pneumococcal disease.

Learning Objectives:

• 1. Duplicate research study within their own population.
• 2. Use findings to support the cost-effectiveness of pneumococcal vaccination.
• 3. Integrate an outreach strategy to increase vaccination rate in their target population.

Keywords: Health Disparities, Managed Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.