Background
Family physicians (FPs) play an important role in influenza vaccination. We investigated
how local FP supply is associated with influenza vaccination, controlling for both
individual-level and county-level characteristics.
Methods
The 2008-2010 individual-level data from the Behavioral Risk Factor Surveillance System
were merged with county-level data from the Area Resource File (n = 985,157). Multivariate
logistic analyses were performed to predict influenza vaccination using the number
of FPs per 1000 population as the key predictor, adjusting for individual-level demographic,
socioeconomic, and health information, as well as county-level racial composition
and income level. Additional analyses were performed across racial/ethnic and employment
status categories.
Results
Increasing local FP supply was associated with higher odds (adjusted odds ratio [aOR],
1.58; 95% confidence interval [CI], 1.49-1.67) and varied across racial/ethnic groups
(Hispanic: aOR, 2.05, 95% CI, 1.55-2.72; non-Hispanic white: aOR, 1.57, 95% CI, 1.48-1.66;
non-Hispanic black: aOR, 1.49, 95% CI, 1.18-1.89), employment status categories, and
county types.
Conclusions
FP supply was significantly associated with influenza vaccination. The association
was greatest among those who were Hispanic, residing in a rural area, or out of work.
Our findings lend support to initiatives aimed at increasing the FP supply, particularly
among disadvantaged populations.
Key Words
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Article info
Publication history
Published online: March 17, 2014
Footnotes
Financial support for this study was provided by the Babson Faculty Research Fund.
Conflict of interest: None to report.
Identification
Copyright
© 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
