Advertisement

Canadian Journal of Public Health

, Volume 94, Issue 5, pp 341–345 | Cite as

The Association Between Influenza Immunization Coverage Rates and Hospitalization for Community-acquired Pneumonia in Alberta

  • Yan Jin
  • Keumhee C. Carriere
  • Gerry Predy
  • David H. Johnson
  • Thomas J. Marrie
Article

Abstract

Background

We compared regional coverage rates of influenza vaccination (composition in 1999/00 was A/Sydney-like A/Beijing-like B/Yamanashi-like and in 2000/01 was A/Moscow A/New Caledonia B/Beijing) to the rates, cost, and mortality for communityacquired pneumonia.

Methods

We used the Pearson’s correlation coefficient to establish linear associations between variables derived from Alberta administrative data during the period April 1, 1999 to March 31, 2001.

Results

The influenza vaccination coverage rate for the 17 health regions varied between 30% to 80% (mean 70%) in Alberta seniors (n=298,473). The annual hospitalization and ambulatory community-acquired pneumonia attack rates were 2% and 6.5% per year respectively. There were strongly negative correlations between vaccination coverage rates and pneumonia rates requiring hospitalization (r1999=-0.59 and r2000=-0.79 with both p<0.05), total per capita physician and hospital costs for pneumonia (r1999=-0.57 and r2000=-0.79 with both p<0.01), community-diagnosed pneumonia rate (r1999=-0.39, p=0.12 and r2000=-0.70, p<0.01) and per capita in-hospital mortality for pneumonia (r1999=-0.30, p=0.24 and r2000=-0.57, p<0.05). Per capita costs, rates, and mortality were highest and influenza vaccinations rate lowest in the northern, remote health regions. The per capita vaccination cost (about $10) was small in relationship to the per capita cost of hospital care for pneumonia (about $100).

Conclusion

Regional under-utilization of preventive influenza vaccination in Alberta seniors is associated with increased utilization of health services for community-acquired pneumonia.

Résumé

Contexte

Nous avons comparé les taux de couverture régionale du vaccin antigrippal (composé en 1999–2000 de souches apparentées à A/Sydney, A/Beijing et B/Yamanashi et en 2000–2001 à A/Moscou, A/Nouvelle-Calédonie et B/Beijing) aux taux, au coût et à la mortalité de la pneumonie acquise dans la communauté.

Méthode

À partir des données administratives de l’Alberta (1er avril 1999 au 31 mars 2001), nous avons utilisé le coefficient de corrélation de Pearson pour établir des associations linéaires entre les variables.

Résultats

Le taux de couverture du vaccin antigrippal chez les aînés des 17 régions sanitaires de l’Alberta (n=298 473) variait de 30 % à 80 % (moyenne 70 %). Les taux annuels de pneumonie communautaire chez les patients hospitalisés et ambulatoires étaient de 2 % et de 6,5 %, respectivement. Nous avons constaté de fortes corrélations négatives entre les taux de couverture vaccinale et les taux de pneumonie nécessitant une hospitalisation (r1999=-0,59 et r2000=-0,79, p<0,05 dans les deux cas), les coûts totaux par habitant en services médicaux et hospitaliers de traitement de la pneumonie (r1999=-0,57 et r2000=-0,79, p<0,01 dans les deux cas), les taux de pneumonie diagnostiquée dans la communauté (r1999=-0,39, p=0,12, et r2000=-0,70, p<0,01) et la mortalité à l’hôpital, par habitant, due à la pneumonie (r1999=-0,30, p=0,24, et r2000=-0,57, p<0,05). Les coûts, les taux et la mortalité par habitant étaient les plus élevés, et les taux de vaccination antigrippale les plus faibles, dans les régions sanitaires éloignées (celles du nord de la province). Le coût de vaccination par habitant (environ 10 $) était faible par rapport au coût par habitant des soins hospitaliers aux malades atteints de pneumonie (environ 100 $).

Conclusion

La sous-utilisation régionale du vaccin antigrippal à titre préventif chez les aînés albertains est associée à une utilisation accrue des services de santé pour traiter la pneumonie communautaire.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    National Advisory Committee on Immunization. Statement on influenza vaccination for the 2000–2001 season. Can Commun Dis Rep 2000;26(ACS-2):1–16.Google Scholar
  2. 2.
    Gross PA, Hermogenes AW, Sacks HS, Lau J, Levandowski, RA. The efficacy of influenza vaccine in elderly persons: A meta-analysis and review of the literature. Ann Intern Med 1995;123:518–27.CrossRefPubMedGoogle Scholar
  3. 3.
    Christenson B, Lundbergh P, Hedlund J, Ortqvist A. Effects of a large-scale intervention with influenza and 23-valent pneumococcal vacines in adults aged 65 years or older: A prospective study. Lancet 2001;357:1008–11.CrossRefPubMedGoogle Scholar
  4. 4.
    Nichol KL, Margolis KL, Wuorenma J, Von Sternberg T. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. N Engl J Med 1994;331:778–84.CrossRefPubMedGoogle Scholar
  5. 5.
    Krieger JW, Castorina JS, Walls ML, Weaver MR, Ciske S. Increasing influenza and pneumococcal immunization rates: A randomized controlled study of a senior center-based intervention. Am J Prev Med 2000;18:123–31.CrossRefPubMedGoogle Scholar
  6. 6.
    Advisory Committee on Immunization Practices. Prevention and control of influenza; recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1998;47(RR-6):1–26.Google Scholar
  7. 7.
    Nichol KL, Baken L, Nelson A. Relation between influenza vaccination and outpatient visits, hospitalization, and mortality in elderly persons with chronic lung disease. Ann Intern Med 1999;130:397–403.CrossRefPubMedGoogle Scholar
  8. 8.
    Draper D, Kahn KL, Reinisch EJ, Sherwood MJ, Carney MF, Kosecoff J, et al. Studying the effects of the DRG based prospective payment system on quality of care. JAMA 1990;264:1956–61.CrossRefPubMedGoogle Scholar
  9. 9.
    Marrie TJ, Durant H, Sealy E. Pneumonia — The quality of medical records. Medical Care 1987;25:20–24.CrossRefPubMedGoogle Scholar
  10. 10.
    Canadian Classification of Diagnostic, Therapeutic, and Surgical Procedures. Second Printing. Ottawa: Statistics Canada Health Division Nosology Reference Centre, Minister of Supply and Services, 1986.Google Scholar
  11. 11.
    Regional Health Authority Global Funding Manual, 2000–01, In: Funding Health. Edmonton, AB: Resourcing Branch, Alberta Health and Wellness, March 2000.Google Scholar
  12. 12.
    Guidelines for Management Information Systems in Canadian Health Service Organizations. Ottawa, ON: Canadian Institute for Health Information, 1999.Google Scholar
  13. 13.
    McKillop I, Pink GH, Johnson, LM. The Financial Management of Acute Care in Canada: A Review of Funding, Performance Monitoring and Reporting Practices. Ottawa, ON: Canadian Institute for Health Information, 2001;83.Google Scholar
  14. 14.
    Magnus SA, Smith, DG. Better Medicare cost report data are needed to help hospitals benchmark costs and performance. Health Care Manage Rev 2000;25:65–76.CrossRefPubMedGoogle Scholar
  15. 15.
    Buchwald D, Sheffield J, Furman R, Hartman S, Dudden M, Manson S. Influenza and pneumococcal vaccination among Native American elders in a primary care practice. Arch Intern Med 2000;160:1443–48.CrossRefPubMedGoogle Scholar
  16. 16.
    Davidson M, Parkinson AJ, Bulkow LR, Fitzgerald MA, Peters HV, Parks, DJ. The epidemiology of invasive pneumococcal disease in Alaska, 1986–1990—ethnic differences and opportunities for prevention. J Infect Dis 1994;170:368–76.CrossRefPubMedGoogle Scholar
  17. 17.
    Smith Sehdev AE, Hutchins, GM. Problems with proper completion and accuracy of the cause-ofdeath statement. Arch Intern Med 2001;161:277–84.CrossRefPubMedGoogle Scholar
  18. 18.
    Heyland DK, Lavery JV, Tranmer J, Shoett SED, Taylor SJ for the Queen’s/KGH End of Life Research Working Group. Dying in Canada: Is it an institutionalized, technologically supported experience? J Palliative Care 2000;16:S10–S16.Google Scholar

Copyright information

© The Canadian Public Health Association 2003

Authors and Affiliations

  • Yan Jin
    • 1
  • Keumhee C. Carriere
    • 2
  • Gerry Predy
    • 3
  • David H. Johnson
    • 4
  • Thomas J. Marrie
    • 5
  1. 1.Information AnalysisAlberta Health and WellnessCanada
  2. 2.Department of Mathematical and Statistical SciencesUniversity of AlbertaCanada
  3. 3.Medical Officer of HealthCapital Health AuthorityCanada
  4. 4.Department of Critical Care MedicineUniversity of AlbertaEdmontonCanada
  5. 5.Department of MedicineCanada

Personalised recommendations