Barbara H. Bardenheier1, Abigail Shefer
2, Linda J. McKibben
3, Henry Roberts
2, and Dale W. Bratzler
4. (1) NIP/ISD/HSREB, CDC, 1600 Clifton Rd, NE, MS-E52, Atlanta, GA, USA, (2) Centers for Disease Control and Prevention, Acting Branch Chief, HSREB, 1600 Clifton Road, NE, MS E-52, Atlanta, USA, (3) CDC/EPO/DPRAM/Office of Health Care Partnerships, 4770 Buford Hwy, Mailstop K-73, Atlanta, Georgia, USA, (4) Oklahoma Foundation for Medical Quality, 5801 Broadway Extension, Suite 400, Oklahoma City, Oklahoma, USA
KEYWORDS:
vaccination, pneumonia, influenza, nursing homes
BACKGROUND:
Studies have found residency in long-term care facilities (LTCFs) to be a risk factor for influenza and pneumonia and have demonstrated that vaccinations against these diseases have reduced the risk of disease and associated complications. During 1999-2002, an inter-agency multi-state demonstration project was conducted in LTCFs to identify factors associated with influenza and pneumococcal vaccination, where rates are far below Healthy People 2010 goals of 90%.
OBJECTIVE:
Identify nursing home resident-specific characteristics associated with vaccination coverage.
METHOD:
Resident-level data including demographics, behavioral, cognitive, and physical functioning, were obtained from the Center for Medicare and Medicaid Services’ Minimum Data Set (MDS) and residents’ vaccination status from on site chart abstractions. Facility-level nursing home characteristics data were collected from self-reported surveys of selected nursing homes in 14 states and from OSCAR, the On-line Survey Certification and Reporting System. Multivariate analysis will be used to determine independent predictors of vaccination status, using hierarchical nonlinear regression to account for similarities among residents from a single facility.
RESULT:
Of 22,195 residents sampled, complete data from all sources was obtained on 18,973 (85%). African-Americans and Hispanics were less likely to receive influenza and pneumococcal vaccinations than others. Bivariate analysis of quality indicators disclosed 1) those with cognitive impairment, mental illness, or neurological problems were more likely to be vaccinated; 2) those with pulmonary disease, cancer, and those with increased prevalence of accidental injuries were less likely to receive either influenza or pneumoccocal vaccines.
CONCLUSION:
Residents of LTCFs with certain characteristics were more likely to be vaccinated than other residents. Interventions such as standing orders should be considered to ensure all those for whom vaccinations are recommended receive them.
LEARNING OBJECTIVES:
Understand risk factors for underimmunization of influenza and pneumococcal vaccines among residents of LTCFs.
See more of What Factors are Associated with Vaccination Coverage in Nursing Homes, and do Influenza and Pneumococcal Vaccines Really Prevent Disease Among Nursing Home Residents?
See more of The 37th National Immunization Conference
