Influenza vaccination: towards better informing patients with ALD

The National Health Insurance Fund (CNAM) is considering how it could improve the information patients with long-term conditions (ALD)-especially for children, the need to receive the vaccine annually against the flu, which in this case is covered by health insurance.

One study suggested that the low influenza vaccination coverage (43.7% in the study) of children with ALD can be explained by the fact that parents and physicians in these young patients often ignore the cost This vaccination is covered by health insurance.

This study was conducted in seven pediatric hospital in the Paris area for children with one of the new ALD (out of 30) for which the vaccine against influenza is covered by health insurance. According to this study, only 15.8% of the parents of these children have reported receiving good care of the vaccine by health insurance.

Asked by Reuters Health, a member of the CNAM indicated that the results of this study were communicated to health insurance. "It worried us and we have verified that our system worked well" for all patients with these new ALD and not only for children, which constitute only a small part of the population. The audit focused on editing and sending good in the database for each new generic ALD (eg severe chronic respiratory failure and hemoglobinopathies) and related diseases (eg severe asthma and sickle cell anemia).

In fact, the study in question has "big way," said the same source. Because of its "hospital recruitment," it has a "representation of hemoglobinopathies and in particular sickle cell." It "is not a reflection of the new ALD" where diabetes and asthma are generally represented and its results "can not [therefore] not be extrapolated."

Concerning the non-receipt of vouchers, this analysis is based on parents' reports from their memories and not the reality of things, says it does the CNAM. Moreover, the fact that only 15.8% of parents of these children that they received the right reflects "perhaps by the fact that patients with sickle cell disease are often of foreign origin" and that there could have a problem understanding the usefulness of good.

Despite these biases, the CNAM is still the "very interesting" study and reflect on the means of action to increase vaccination coverage among patients with ALD, including children.

Health insurance publishes "long" cards for each of the nine ALD concerned. Intended to be given to patients by their general practitioner or family doctor, unfortunately they are often made available in waiting rooms rather than being delivered by hand during the consultations, deplores the representative of the CNAM.

Efforts should also be made at the hospital doctors should also be able to recover these files, such as GPs. Finally, documents with a pediatric shade should be developed, he added.

The authors of the pediatric study also suggested that the low rate of vaccination in children with chronic obstructive pulmonary disease may be explained by the difference between recommendations and implementation ALD uncommon for children asthmatic disease.

The current criteria for severe asthma in ALD, corresponding to severe chronic respiratory failure seem especially suitable for adults. The group of pediatricians involved will therefore consider a definition for the child more easily measurable criteria and possibly seize the High Authority for Health (HAS) on the subject, does it indicate the CNAM.