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The impact of influenza vaccination on hospitalizations and mortality among frail older people.

Abstract

OBJECTIVES

The objective of this study was to evaluate the benefits of influenza vaccination against hospitalization and mortality on frail elderly people.

DESIGN

The design was a population-based retrospective cohort study.

SETTING

Taiwan's National Health Insurance claims data.

PARTICIPANTS

Participants were 5063 frail seniors, followed up for four years.

MEASUREMENTS

Measurements included age, gender, socioeconomic status, living areas, use of annual health examinations, comorbid conditions, use of influenza vaccine, frailty as defined by the Adjusted Clinical Group, hospitalization, and mortality in the observation period. The efficacy was presented as comparing ever versus never vaccinated people during the entire study period without regard to seasons.

RESULTS

Compared with those without influenza vaccination, vaccinated elderly individuals were younger, more likely to be men, have higher socioeconomic status, live in rural areas, have a higher rate of receiving a health examination, and have similar medical conditions. In the Cox proportional hazards analysis, influenza vaccination reduced by 7% the risk of hospitalization (95% confidence interval [CI] 0.86-0.99) and by 44% the risk of mortality (95% CI 0.51-0.62).

CONCLUSION

Influenza vaccination was effective against hospitalization and mortality among the frail elderly. These results uphold the current universal influenza vaccination policy, and encourage policymakers to adopt strategies to improve vaccination use.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Division of Geriatric Medicine, Taipei Veterans General Hospital, Yuan Shan Branch, I-Lan County, Taiwan.

    ,

    Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.

    ,

    Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.

    Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan. Electronic address: tylan@ym.edu.tw.

    Source

    MeSH

    Aged
    Aged, 80 and over
    Female
    Frail Elderly
    Hospitalization
    Humans
    Immunization Programs
    Influenza Vaccines
    Influenza, Human
    Insurance Claim Review
    Male
    Retrospective Studies
    Taiwan

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    24559640

    Citation

    Lee, Wei-Ju, et al. "The Impact of Influenza Vaccination On Hospitalizations and Mortality Among Frail Older People." Journal of the American Medical Directors Association, vol. 15, no. 4, 2014, pp. 256-60.
    Lee WJ, Chen LK, Tang GJ, et al. The impact of influenza vaccination on hospitalizations and mortality among frail older people. J Am Med Dir Assoc. 2014;15(4):256-60.
    Lee, W. J., Chen, L. K., Tang, G. J., & Lan, T. Y. (2014). The impact of influenza vaccination on hospitalizations and mortality among frail older people. Journal of the American Medical Directors Association, 15(4), pp. 256-60. doi:10.1016/j.jamda.2013.12.003.
    Lee WJ, et al. The Impact of Influenza Vaccination On Hospitalizations and Mortality Among Frail Older People. J Am Med Dir Assoc. 2014;15(4):256-60. PubMed PMID: 24559640.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The impact of influenza vaccination on hospitalizations and mortality among frail older people. AU - Lee,Wei-Ju, AU - Chen,Liang-Kung, AU - Tang,Gau-Jun, AU - Lan,Tzuo-Yun, Y1 - 2014/02/20/ PY - 2013/11/13/received PY - 2013/12/02/accepted PY - 2014/2/25/entrez PY - 2014/2/25/pubmed PY - 2014/12/15/medline KW - Influenza vaccination KW - death KW - hospitalization KW - older adults SP - 256 EP - 60 JF - Journal of the American Medical Directors Association JO - J Am Med Dir Assoc VL - 15 IS - 4 N2 - OBJECTIVES: The objective of this study was to evaluate the benefits of influenza vaccination against hospitalization and mortality on frail elderly people. DESIGN: The design was a population-based retrospective cohort study. SETTING: Taiwan's National Health Insurance claims data. PARTICIPANTS: Participants were 5063 frail seniors, followed up for four years. MEASUREMENTS: Measurements included age, gender, socioeconomic status, living areas, use of annual health examinations, comorbid conditions, use of influenza vaccine, frailty as defined by the Adjusted Clinical Group, hospitalization, and mortality in the observation period. The efficacy was presented as comparing ever versus never vaccinated people during the entire study period without regard to seasons. RESULTS: Compared with those without influenza vaccination, vaccinated elderly individuals were younger, more likely to be men, have higher socioeconomic status, live in rural areas, have a higher rate of receiving a health examination, and have similar medical conditions. In the Cox proportional hazards analysis, influenza vaccination reduced by 7% the risk of hospitalization (95% confidence interval [CI] 0.86-0.99) and by 44% the risk of mortality (95% CI 0.51-0.62). CONCLUSION: Influenza vaccination was effective against hospitalization and mortality among the frail elderly. These results uphold the current universal influenza vaccination policy, and encourage policymakers to adopt strategies to improve vaccination use. SN - 1538-9375 UR - https://www.unboundmedicine.com/medline/citation/24559640/The_impact_of_influenza_vaccination_on_hospitalizations_and_mortality_among_frail_older_people_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1525-8610(13)00672-5 DB - PRIME DP - Unbound Medicine ER -