Ronald Tiggle1, Jill Marsteller
2, Robin Remsburg
3, Abigail Shefer
4, and Barbara H. Bardenheier
4. (1) Division of Health Care Statistics, Long Term Care Statistics Branch, National Center for Health Statistics, 3311 Toledo Rd., Room 3429, Hyattsville, MD, USA, (2) Division of Heatlh Care Statistics/Hospital Care Statistics Branch, National Center for Health Statistics, 3311 Toledo Rd., Room 3312, Hyattsville, MD, USA, (3) Division of Health Care Statistics, Long Term Care Statistics Branch, National Center for Health Statistics, 3311 Toledo Rd, Hyattsville, MD, USA, (4) NIP/ISD/HSREB, CDC, 1600 Clifton Rd, NE, MS-E52, Atlanta, USA
BACKGROUND:
Although pneumonia has the highest mortality rate of any infection occurring in nursing homes, pneumococcal immunization remains underutilized.
OBJECTIVE:
To identify resident and facility characteristics associated with not receiving or having an unknown pneumococcal immunization; and to determine the differences in these characteristics among black and white residents.
METHOD:
Multinomial logistic regression using a nationally representative aggregated sample for 1997/1999 of nursing home residents >=65 (n=14,782) in three groups (overall, black, and white). The outcome is record-based staff report of whether residents ever had a pneumococcal immunization (yes/no/unknown).
RESULT:
In the aggregated sample, 24% of residents >=65 never received, and 42% had an unknown, pneumococcal immunization status. Residents not immunized for influenza, residing in proprietary facilities compared to government-owned, in facilities without an organized immunization program, and in southern or Midwestern facilities are more likely not to receive immunization for pneumonia or to have an unknown status. Residents who are black, reside in Medicaid-only or noncertified facilities, and do not need help with feeding are more likely not to receive pneumonia immunization. For white residents, residing in facilities that were proprietary, noncertified, and in the south were associated with not receiving immunization. However, for black residents these variables were not associated with receiving pneumococcal immunization.
CONCLUSION:
Residents in facilities that have an organized immunization program are more likely to be immunized. However, many residents do not receive immunization or have an unknown status. A racial disparity for pneumococcal immunization exists, with whites more likely to be immunized. Targeted strategies addressing racial differences in immunization and improving documentation of immunization to decrease residents with unknown status should be identified.
LEARNING OBJECTIVES:
Identify resident and facility characteristics associated with receiving pneumococcal vaccination.
Understand the role of resident and facility characteristics in explaining disparities in pneumococcal immunization for black residents.
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