Characteristics Associated With Homebound Vaccination Against COVID-19.
Jennifer Ren, Anish Kumar, Duzhi Zhao and 2 others
PMID 39004101WHAT IT FOUND
Homebound patients vaccinated through a home-based primary care program were more likely to have dementia, Medicaid, public housing, longer enrollment, and neighborhoods with lower computer and internet use and greater poverty than patients vaccinated elsewhere.
Key findings
01Of 795 eligible patients, 416 were vaccinated through the home-based primary care program, 263 were vaccinated elsewhere, and 116 remained unvaccinated.
02Compared with patients vaccinated elsewhere, patients vaccinated through the home-based primary care program were more likely to have a history of dementia, live in public housing, have Medicaid, have fewer Elixhauser comorbidities, and have been enrolled for more than four years.
03Compared with patients vaccinated elsewhere, patients vaccinated through the home-based primary care program were more likely to live in neighborhoods with lower proportions of US-born residents, lower English proficiency, lower computer and internet usage, and greater below-poverty levels.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was observational and cross-sectional, so it can show associations but not whether home-based vaccination caused patients to be vaccinated. Patients were not randomized because all eligible patients were offered home vaccination during the pandemic. The study included one urban home-based primary care program in New York City, so results may not apply to other homebound populations or to vaccination campaigns run independently of the program. Data quality was limited for race/ethnicity, homebound status, caregiver vaccination status, and reasons behind vaccination decisions. Homebound status was defined by program enrollment, and levels of functional impairment were not considered. The multivariable model was omitted because of low explanatory power, so independent associations are not established. Missing data were omitted from calculations and tests, with Elixhauser comorbidities having 12% missingness.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that home-based vaccination increased vaccination rates or that trusted provider relationships caused patients to be vaccinated. The study was observational, patients were not randomized, and the multivariable model was omitted due to low explanatory power.