Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, Box G-S121-3, Providence, RI, 02912, USA.
Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI, USA.
BMC Geriatr. 2022 Nov 4;22(1):835. doi: 10.1186/s12877-022-03540-3.
Influenza vaccination varies widely across long-term care facilities (LTCFs) due to staff behaviors, LTCF practices, and patient factors. It is unclear how seasonal LTCF vaccination varies between cohabitating but distinct short-stay and long-stay residents. Thus, we assessed the correlation of LTCF vaccination between these populations and across seasons.
The study design is a national retrospective cohort using Medicare and Minimum Data Set (MDS) data. Participants include U.S. LTCFs. Short-stay and long-stay Medicare-enrolled residents age ≥ 65 in U.S. LTCFs from a source population of residents during October 1-March 31 in 2013-2014 (3,042,881 residents; 15,683 LTCFs) and 2014-2015 (3,143,174, residents; 15,667 LTCFs). MDS-assessed influenza vaccination was the outcome. Pearson correlation coefficients were estimated to assess seasonal correlations between short-stay and long-stay resident vaccination within LTCFs.
The median proportion of short-stay residents vaccinated across LTCFs was 70.4% (IQR, 50.0-82.7%) in 2013-2014 and 69.6% (IQR, 50.0-81.6%) in 2014-2015. The median proportion of long-stay residents vaccinated across LTCFs was 85.5% (IQR, 78.0-90.9%) in 2013-2014 and 84.6% (IQR, 76.6-90.3%) in 2014-2015. Within LTCFs, there was a moderate correlation between short-stay and long-stay vaccination in 2013-2014 (r = 0.50, 95%CI: 0.49-0.51) and 2014-2015 (r = 0.53, 95%CI: 0.51-0.54). Across seasons, there was a moderate correlation for LTCFs with short-stay residents (r = 0.54, 95%CI: 0.53-0.55) and a strong correlation for those with long-stay residents (r = 0.68, 95%CI: 0.67-0.69).
In LTCFs with inconsistent influenza vaccination across seasons or between populations, targeted vaccination protocols for all residents, regardless of stay type, may improve successful vaccination in this vulnerable patient population.
由于员工行为、长期护理机构（LTCF）的做法和患者因素，流感疫苗在 LTCF 中的接种情况差异很大。目前尚不清楚季节性 LTCF 疫苗接种在共同居住但不同短期和长期居民之间有何差异。因此，我们评估了这些人群之间以及整个季节中 LTCF 疫苗接种的相关性。
本研究设计是一项全国性的回顾性队列研究，使用了 Medicare 和最低数据集（MDS）数据。参与者包括美国 LTCF。来自 2013-2014 年（3042881 名居民；15683 家 LTCF）和 2014-2015 年（3143174 名居民；15667 家 LTCF）10 月 1 日至 3 月 31 日居住在 US LTCF 中的 Medicare 参保年龄≥65 岁的短期和长期居民是本研究的目标人群。MDS 评估的流感疫苗接种是结局。使用 Pearson 相关系数来评估 LTCF 内短期和长期居民疫苗接种的季节性相关性。
2013-2014 年，LTCF 中短期居民疫苗接种的中位数比例为 70.4%（IQR，50.0-82.7%），2014-2015 年为 69.6%（IQR，50.0-81.6%）。2013-2014 年，LTCF 中长期居民疫苗接种的中位数比例为 85.5%（IQR，78.0-90.9%），2014-2015 年为 84.6%（IQR，76.6-90.3%）。在 LTCF 中，2013-2014 年（r=0.50，95%CI：0.49-0.51）和 2014-2015 年（r=0.53，95%CI：0.51-0.54），短期和长期居民疫苗接种之间存在中度相关性。在整个季节中，对于短期居民的 LTCF 存在中度相关性（r=0.54，95%CI：0.53-0.55），而对于长期居民的 LTCF 存在高度相关性（r=0.68，95%CI：0.67-0.69）。
在流感疫苗接种在不同季节或不同人群之间不一致的 LTCF 中，针对所有居民（无论居住类型如何）的有针对性的疫苗接种方案可能会改善这一脆弱患者群体的成功接种。
