U.S. cases in 1968: epidemiology of echovirus 30 aseptic meningitis.
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Adolescent↗
Biomedical subjects
R S Thompson
Publications and source records attributed to R S Thompson.
Evaluation of Group Health Cooperative of Puget Sound's Senior Influenza Immunization Program.
The goal of this study was to identify areas in which an influenza immunization campaign for seniors, sponsored by a health maintenance organization (HMO), could be improved. This study was conducted at Group Health Cooperative of Puget Sound (GHC), serving approximately 470,000 enrollees in Washington State. A survey was administered to two groups of seniors drawn at random--those who received influenza vaccine and those who did not, during the fall and winter of 1991. Immunization rates were almost 75 percent for "well" seniors and 85 percent for "chronically ill" seniors. Bivariant analysis showed that two activities of the influenza campaign were associated with vaccine compliance: a provider-generated recruitment letter and exposure to an immunization article in the enrollee newsletter. Using a broader framework for predicting vaccine compliance, logistic regression showed that vaccine compliance was associated positively with previous immunizations and belief that "my doctor wants me to get a shot," and negatively with fear of adverse reaction and belief that the vaccine is ineffective. There were few suggestions for improving the immunization program, among both vaccinated and unvaccinated enrollees. Approximately two-thirds of unvaccinated enrollees said there was nothing GHC could do to convince them to be vaccinated. These findings suggest high vaccine compliance and satisfaction with an HMO-sponsored influenza campaign. Strategies and potential to further increase vaccination rates are discussed.
Aged↗
Use of behavioral risk factor surveys to predict alcohol-related motor vehicle events.
The relationship between acute alcohol intoxication and increased risk of traffic violations, crashes, and injuries is well known. We designed this study to investigate the usefulness of behavioral risk factor surveys (BRFSs) in identifying drivers at risk for subsequent motor vehicle violations and crashes. We carried out a retrospective cohort study in a random sample of members of a health maintenance organization, who were followed for five years after ascertainment of alcohol use. Reported problem drinking behavior increased the risk of motor vehicle violations or crashes for women drivers and older drivers (older than 65 years of age) of both sexes. Women "binge drinkers" had an age-adjusted relative risk (RR) for violations of 1.7 (95% confidence interval [CI] = 1.1, 2.8) and an age-adjusted RR for crashes of 1.9 (95% CI = 1.1, 3.2). Older drivers reporting drinking and driving or multiple drinking problems had an increased risk of motor vehicle crashes (sex-adjusted RR = 2.7; 95% CI = 1.2, 5.8, and 3.0; 95% CI = 1.1, 8.4). A CAGE score of 2 or more identified older drivers at increased risk for both violations and crashes. We found no increased risk for male drivers under 65 years of age for any of the problem drinking behaviors. We conclude that BRFSs in a general population can help identify high-risk drivers among women and drivers older than 65 years of age.
Accidents, Traffic↗
Development and validation of an immunization tracking system in a large health maintenance organization.
Practitioners seeing individual patients and those charged with improving immunization practices in that population need accurate information on the epidemiology of immunizations within the population. To meet this need, we have developed a computer-based record of data required by the National Childhood Vaccine Injury Act of 1986 for all immunizations given to 350,000 enrollees in a large health maintenance organization. In the first eight months of operation, 102,271 immunizations representing 11 separate antigens given to 65,676 enrollees were entered into the database. Comparison of immunizations given and recorded in the medical record with the database shows that the system has high sensitivity, specificity, and positive predictive value, but a relatively low negative predictive value. The database is being used for analysis of current immunization practices for Haemophilus influenzae b vaccine and for research on adverse outcomes of childhood immunizations.
Databases, Factual↗
A review of clinical prevention services at group health cooperative of Puget Sound.
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Breast Neoplasms↗
Treatments and outcomes of nursing-home-acquired pneumonia.
BACKGROUND: Bronchopulmonary infections have been considered the leading cause of hospital admissions and death in the nearly 2 million nursing home residents in the United States. Very little is known about the treatments and outcomes of this entity. The purpose of our study was to document the incidence, treatments, and outcomes of nursing-home-acquired pneumonia in hospitalized and nonhospitalized patients. METHODS: We conducted a retrospective chart review during a 24-month period of patients from two community nursing homes in upstate New York with a total average population of 330 residents. The main outcome measure was 6-week mortality. RESULTS: Pneumonia was diagnosed in 129 patients, whose overall 6-week mortality rate was 24.8 percent. Ninety-one patients were cared for in the nursing home, and 38 patients were hospitalized. Six-week mortality rate for the nonhospitalized group was 18.7 percent. The hospitalized group's 6-week mortality rate was significantly higher at 39.5 percent. There were no significant differences between the hospitalized and nonhospitalized groups before their diagnosis that predicted outcome. CONCLUSIONS: For many patients nursing-home-acquired pneumonia can be successfully treated in a nursing home with oral antibiotics at a considerable cost savings when compared with hospitalization.
Administration, Oral↗