2170. The National Burden of Pneumonia and Influenza in U.S. Nursing Homes, 2013–2015

Abstract

BackgroundNational data on pneumonia and influenza (P&I) morbidity is lacking for the U.S. nursing home (NH) population. Our primary objective was to determine the incidence of hospitalization due to P&I.MethodsThis retrospective cohort used nursing home Minimum Data Set clinical assessments and Medicare claims for U.S. nursing home residents. Any resident who stayed in a nursing home from January 1, 2013 through December 31, 2015 was included and classified as short-stay or long-stay (≥100 days in the home). Residents <65 years old or enrolled in an HMO plan were excluded. Hospitalizations due to P&I were identified in the first position on Part A claims (ICD9 diagnoses 480.xx–488.xx). Outcomes were reported for 2013–2014, to allow 1-year forward evaluation.ResultsThe study cohort comprised 4.2 million NH residents with 2.9 (69%) million short stays. Mean age (SD) was 80.5 (8.4) for short-stays vs. 83.0 (8.5) years for long-stays. Long-stay residents were more likely to be female (66.3% vs. 60.4%), African-American (10.9% vs. 6.6%) and Hispanic (4.1% vs. 2.8%). For long-stay residents, 23.7% had documented coronary artery disease, 23.2% congestive heart failure, 33.2% diabetes and 47.9% dementia. Incidence proportions are reported in Table 1. Short-stay and long-stay residents have a similar risk of hospitalization due to P&I at 1 year (4.1% vs. 4.5%).Table 1.Incidence of P&I Hospitalizations in Nursing Homes, 2013–2014Short-Stay Residents (n = 1,790,388)Long-Stay Residents (n = 873,254)30-day19,122 (1.1%)4,656 (0.5%)180-day50,433 (2.8%)22,156 (2.5%)365-day72,948 (4.1%)39,355 (4.5%)ConclusionThe national incidence of one-year P&I hospitalization was 4.1 and 4.5% among short-stay and long-stay NH residents. Vaccination, prompt diagnosis and treatment, hand-washing and environmental cleaning are all important interventions which can further reduce the morbidity of this disease.Disclosures K. Mcconeghy, Sanofi-Pasteur: Collaborator, Research support. A. Zullo, Sanofi-Pasteur: Collaborator, Research grant. R. Van Aalst, Sanofi-Pasteur: Employee, Salary. A. Chit, Sanofi-Pasteur: Employee, Salary. S. Gravenstein, Sanofi-Pasteur: Grant Investigator, Grant recipient, Research grant and Research support; Sequiris: Grant Investigator, Grant recipient, Research grant and Research support. V. Mor, Sanofi-Pasteur: Grant Investigator, Grant recipient, Research grant and Research support. Sequiris: Grant Investigator and Investigator, Grant recipient, Research grant and Research support.