Dale W. Bratzler1, Lynn Steele
2, Wato Nsa
1, Abigail Shefer
2, Linda J. McKibben
3, Jennifer O'Hagan
1, and John Jernigan
2. (1) Oklahoma Foundation for Medical Quality, 14000 Quail Springs Parkway, Suite 400, Oklahoma City, OK, USA, (2) Centers for Disease Control and Prevention, (3) CDC/EPO/DPRAM/Office of Health Care Partnerships, 4770 Buford Hwy, Mailstop K-73, Atlanta, Georgia, USA
KEYWORD1:
Adult vaccination, Nursing home, Health outcomes
BACKGROUND:
Long-term care facility (LTCF) residents are at high risk of complications from influenza and pneumococcal disease. As part of the CDC/CMS Immunization Standing Orders Project, we examined rates of hospitalization and mortality for LTCF residents stratified by vaccination status.
OBJECTIVE:
To evaluate the impact of influenza and pneumococcal vaccines on hospitalizations and death in LTCF residents.
METHOD:
In this retrospective cohort study, chart abstraction for vaccination status was completed on 22,317 residents (resident between November 1, 2000, and January 31, 2001) of 273 LTCFs in 14 states. Abstracted data was linked to the Medicare enrollment database and national Medicare claims history, and the complete Minimum Data Set (MDS) file was obtained for each resident. The outcomes of interest were death or hospitalization prior to April 1, 2001. All outcomes were risk-adjusted in multivariate analysis for patient age, gender, race, and for variables from MDS that were significantly associated in univariate analysis with patient outcomes (cancer, renal failure, heart disease, pneumonia, and activities of daily living score).
RESULT:
There were 19,413 patients with complete data linkage available for analysis. The study population was 70% female. The majority of patients (80%) were 75 years of age or older. There were 3,637 (18.7%) patients who died and 6,249 (32.2%) who had at least one hospital admission during the time frame studied. In multivariate analysis, influenza vaccine [adjusted odds ratio (aOR) 0.53, 95% CI 0.49-0.58; P<.001)] and pneumococcal vaccine (aOR 0.76, 95% CI 0.69-0.83; P<.001) were associated with a reduced risk of death. Similarly, influenza vaccine (aOR 0.36, 95% CI 0.34-0.39; P<.001) and pneumococcal vaccine (aOR 0.64, 95% CI 0.59-0.69; P<.001) were associated with a reduced risk of hospitalization.
CONCLUSION:
In this cohort of LTCF patients, the risk of hospitalization and death was significantly reduced among those who received influenza or pneumococcal vaccines.
LEARNINGOBJECTIVES:
1. To understand the impact of influenza and pneumococcal disease on nursing home residents.
2. To describe the effectiveness of these vaccines for this population of patients.
Web Page:
www.nationalpneumonia.org
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
