Better Patient Experience is Associated with Better Vaccine Uptake in Older Adults: Multicentered Cross-sectional Study

Journal of General Internal Medicine volume 35, pages3485–3491(2020)Cite this article

Abstract

Background

Older adults’ uptake of influenza and pneumococcus vaccines is insufficient worldwide. Although patient experience of primary care is associated with vaccine uptake in children, this relationship remains unclear for older adults.

Objective

This study examined the association between patient experience of primary care and influenza/pneumococcal vaccine uptake in older adults.

Design and Methods

We conducted a multicentered cross-sectional survey involving 25 primary care institutions in urban and rural areas in Japan. Participants were outpatients aged ≥ 65 years who visited one of the participating institutions within the 1-week study period. We assessed patient experience of primary care using the Japanese version of the Primary Care Assessment Tool (JPCAT), which includes six domains: first contact (accessibility), longitudinality (continuity of care), coordination, comprehensiveness (services available), comprehensiveness (services provided), and community orientation. We used a generalized linear mixed-effects model to adjust for clustering within institutions and individual covariates.

Key Results

One thousand participants were included in the analysis. After adjusting for clustering within institutions and other possible confounders, influenza and pneumococcal vaccine uptake was positively associated with JPCAT total scores (odds ratio per 1 standard deviation increase: 1.19, 95% confidence interval: 1.01–1.40 and odds ratio: 1.26, 95% confidence interval: 1.08–1.46, respectively). Of the JPCAT domains, coordination and community orientation were associated with influenza vaccine uptake and longitudinality, coordination, and comprehensiveness were associated with pneumococcal vaccine uptake.

Conclusions

Influenza and pneumococcal vaccine uptake were positively associated with patient experience of primary care in older adults. Consideration of patient experience, particularly longitudinality, coordination, comprehensiveness, and community orientation, could improve vaccine uptake.

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Figure 1

Data Availability

The datasets generated and analyzed during the current study are not publicly available because we did not receive informed consent concerning data sharing from the participants.

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Acknowledgments

We thank the primary care facilities that participated in the PROGRESS 2018 for their contribution.

Funding

This work was supported by Institute for Health Economics and Policy, Japan.

Author information

Author notes

  1. Makoto Kaneko and Takuya Aoki are equal contribution.

Affiliations

  1. Department of Family and Community Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Makoto Kaneko MD, PhD

  2. Shizuoka Family Medicine Program, Shizuoka, Japan

    Makoto Kaneko MD, PhD

  3. Primary Care Research Unit, Graduate School of Health Data Science, Yokohama City University, Yokohama, Kanagawa, Japan

    Makoto Kaneko MD, PhD

  4. Division of Clinical Epidemiology, Jikei University School of Medicine, Tokyo, Japan

    Takuya Aoki MD, MMA, PhD

  5. Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Takuya Aoki MD, MMA, PhD

  6. Faculty of Medicine, University of Tsukuba, Ibaraki, Japan

    Ryohei Goto PT, PhD, Sachiko Ozone MD, PhD & Junji Haruta MD, PhD

  7. Medical Education Center, School of Medicine, Keio University, Tokyo, Japan

    Junji Haruta MD, PhD

Authors
  1. Makoto Kaneko MD, PhD
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  2. Takuya Aoki MD, MMA, PhD
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  3. Ryohei Goto PT, PhD
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  4. Sachiko Ozone MD, PhD
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  5. Junji Haruta MD, PhD
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Corresponding author

Correspondence to Makoto Kaneko MD, PhD.

Ethics declarations

This study was approved by the Research Ethics Committee of Kyoto University, Japan (approval number R1342).

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Prior Presentations

We presented about part of this study at the annual conference of the Japanese Primary Care Association in May 2019.

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Kaneko, M., Aoki, T., Goto, R. et al. Better Patient Experience is Associated with Better Vaccine Uptake in Older Adults: Multicentered Cross-sectional Study. J GEN INTERN MED 35, 3485–3491 (2020). https://doi.org/10.1007/s11606-020-06187-1

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KEY WORDS

  • older adults
  • patient experience
  • vaccination