The impact of a quality improvement continuing medical education intervention on physicians’ vaccination practice: a controlled study

Figures & data

Table 1. Number of patient records analyzed

Measure	Total Baseline (Stage A)	Total Stage C
Influenza: patients aged ≥ 65 years	98,064 Test: 49,032 Control: 49,032	104,906 Test: 52,453 Control: 52,453
Influenza: high-risk patients aged 18-64	73,028 Test: 36,514 Control: 36,514	75,890 Test: 37,945 Control: 37,945
Pneumococcal: patients aged ≥ 65 years	98,084 Test: 49,042 Control: 49,042	104,758 Test: 52,379 Control: 52,379
Pneumococcal: high-risk patients aged 18-64	73,130 Test: 36,565 Control: 36,565	75,974 Test: 37,987 Control: 37,987

Patient records analyzed in the test and control group. A propensity score 1:1 matched Test:Control cohort analysis was performed resulting in the same number of patient records analyzed from the test and control group in each stage.

Table 2. Vaccination rates at baseline (Stage A) and after the intervention (Stage C) for influenza and pneumococcal vaccination in those aged ≥ 65 years and with high-risk factors

OUTCOME
	Influenza 65+			Influenza High-Risk			Pneumococcal 65+			Pneumococcal High- Risk
GROUP	Baseline (Stage A)	Stage C	P	Baseline (Stage A)	Stage C	P	Baseline (Stage A)	Stage C	P	Baseline (Stage A)	Stage C	P
Intervention Group	56.2%	58.7%	<0.001	38.6%	40.4%	<0.001	80.6%	82.7%	<0.001	40.4%	43.8%	<0.001
Control Group	39.3%	38.4%	= 0.003	28.7%	28.4%	= 0.347	56.7%	58.2%	<0.001	28.5%	30.5%	<0.001
Difference Intervention vs. Control, P	3.4 <0.001			2.1 <0.001			0.6 <0.001			1.4 <0.059

Table 3. Impact of the intervention on the vaccination rates odds ratio associated to baseline and completed stages

Vaccine	Population	Baseline (Stage A) Odds Ratio (95% CI)	Stage C Completers Odds Ratio (95% CI)	p Value
Influenza	>65 years	1.98 (1.93–2.03)	2.27 (2.22–2.33)	<0.0001*
	High-risk	1.56 (1.51–1.61)	1.70 (1.65–1.76)	<0.0001*
Pneumonia	>65 years	3.16 (3.07–3.25)	3.43 (3.34–3.53)	<0.0001*
	High-risk	1.70 (1.65–1.75)	1.77 (1.72–1.83)	NS

*statistically significant by Breslow-Day test for homogeneity of the odds ratio (p < 0.05); CI = confidence interval; NS = not significant