Influenza vaccination and its impact on hospitalization events in nursing homes.

Abstract

To examine trends of influenza vaccination in nursing homes before and after public reporting (objective-1), and to assess the effect of influenza vaccinations on hospitalization events (objective-2). Nursing Home Compare (NHC) database was used to obtain influenza vaccination rates during the 2005-2006, 2006-2007, and 2007-2008 flu seasons (objective-1). The 2005-2007 Minimum Data Set for New York State (NYS) was obtained and linked with the NHC data (objective-2). All nursing homes in the United States were included in the analysis of objective-1. All eligible NYS nursing homes and their residents, during 2005-2006 and 2006-2007 flu seasons, were included in the analysis of objective-2. Nursing home was the unit of analysis. Influenza vaccination rates in nursing homes over the 3 flu seasons were compared nationwide. A first-differenced model was fit to examine the relationship between facility vaccination rates and hospitalization rates in NYS. There was an increase in influenza vaccination rates in nursing homes over the 3 flu seasons, but this increase was no greater than that among community-dwelling elderly. In NYS facilities with high baseline vaccination rates, the effect of vaccination on reducing hospitalizations was small. In NYS facilities with a low baseline rate, a 10.0% increase in vaccination rate for long-term care residents was correlated with a 6.2% decline in baseline hospitalization rates. However, a 10.0% increase in vaccination rate for short-term care residents was correlated with a 4.6% increase in baseline hospitalization rates. There is no clear evidence that public reporting improves vaccination rates in nursing homes. The effects of vaccination on hospitalization events in nursing homes are mixed.