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Characteristics of Long-Term–Care Facility Residents Associated With Receipt of Influenza and Pneumococcal Vaccinations

Published online by Cambridge University Press:  02 January 2015

Barbara Bardenheier ,
Abigail Shefer ,
Linda McKibben ,
Henry Roberts  and
Dale Bratzler
Barbara Bardenheier*
Affiliation:
Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Abigail Shefer
Affiliation:
Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Linda McKibben
Affiliation:
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Henry Roberts
Affiliation:
Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Dale Bratzler
Affiliation:
Oklahoma Foundation for Medical Quality, Oklahoma City, Oklahoma
*
Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-52, Atlanta, GA 30333
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Abstract

Background:

Studies have found residency in long-term–care facilities (LTCFs) a risk factor for influenza and pneumonia and have demonstrated that vaccinations against these diseases reduce the risk of disease. However, rates are below Healthy People 2010 goals of 90% for LTCFs. During 1999–2002, a multi-state demonstration project was conducted in LTCFs to implement standing orders programs for immunizations.

Objective:

Identify nursing home resident–specific characteristics associated with vaccination coverage at baseline.

Methods:

Facility-level data were collected from self-reported surveys of selected nursing homes in 14 states and from the On-line Survey and Certification Reporting System. Resident-level data, including demographics and physical functioning, were obtained from the Centers for Medicare & Medicaid Services' Minimum Data Set; 2000–2001 vaccination status was obtained by chart review. Influenza vaccination status reflected a single season, whereas pneumococcal vaccination status reflected vaccination in the past. Multilevel analysis was used to control for facility-level variation.

Results:

Of 22,188 residents sampled in 249 LTCFs, complete data were obtained for 20,516 (92%). The average coverage for immunizations was 58.5% ± 0.7% for influenza and 34.6% ± 0.3% for pneumococcal. On bivariate analyses, residents with cognitive, psychiatric, or neurologic problems were more likely to be vaccinated; those with accidental injuries, unstable conditions, or cancer were less likely to receive either vaccine. On multilevel analysis, the strongest resident characteristics associated with receipt of immunizations, controlling facility variation, were cognitive deficits and psychiatric illness.

Conclusion:

The variation in baseline vaccination coverage associated with LTCF resident characteristics supports the need for strategies to increase vaccination coverage in LTCFs.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 11 , November 2004 , pp. 946 - 954
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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