Disparities in Influenza Vaccination Linked to Poorer Results on Measures of Quality Care
Racial and ethnic disparities in influenza vaccination among adults in nursing homes (NHs) are well documented. A new study in the June issue of JAMDA suggests where these disparities may be the greatest and the reasons behind them.
In Decomposing Racial and Ethnic Disparities in Nursing Home Influenza Vaccination, the authors analyzed data for 630,373 short-stay and 1,029,593 long-stay residents. They found that among short-stay residents, the proportion vaccinated against influenza was 67.2% for White residents, 55.1% for Black residents, and 54.5% for Hispanic residents. The numbers were higher for long-stay residents, at 84.2%, 76.7%, and 80.8%, respectively.
The characteristics associated with decreased likelihood of influenza vaccination among short-stay residents included for-profit facilities and/or those with a greater proportion of Medicare as primary payer, higher acuity index, percent of residents on an antipsychotic, and certified nursing assistant (CNA) hours per resident. The authors noted that low vaccination rates may affect all individuals if ambulatory short-stay residents are able to move freely around the facility, potentially exposing others to respiratory illness.
The authors concluded that “measures associated with NH quality of care were important positive contributors to the disparity in influenza vaccination. They added, “Tracking vaccination rates in NHs to detect and intervene locally upon racial/ethnic differences may mitigate disparities until more detailed qualitative data is available to inform improvements to healthcare policy.”
The study was conducted by researchers at the Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI; Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI; Department of Epidemiology, Brown University School of Public Health, Providence, RI,; Center for Long-Term Care Quality & Practice, Brown University School of Public Health, Providence, RI; Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI; Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI; Sanofi Pasteur, Swiftwater, PA; Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; and the Leslie Dan School of Pharmacy, University of Toronto, Ontario, Canada.
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JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.