Learning Objectives for this Presentation:
By the end of the presentation participants will be able to;
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


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.

Objectives:
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:
Considering potential costs of hospitalization for pneumococcal illness, telephone intervention was relatively inexpensive and successful at raising vaccination rates.