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Geographic Variation in Influenza Vaccination Disparities Between Hispanic and Non-Hispanic White US Nursing Home Residents.
Riester, Melissa R; Roberts, Anthony I; Silva, Joe B B; Howe, Chanelle J; Bardenheier, Barbara H; van Aalst, Robertus; Loiacono, Matthew M; Zullo, Andrew R.
Affiliation
  • Riester MR; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
  • Roberts AI; Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, Rhode Island, USA.
  • Silva JBB; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
  • Howe CJ; Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, Rhode Island, USA.
  • Bardenheier BH; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
  • van Aalst R; Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, Rhode Island, USA.
  • Loiacono MM; Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
  • Zullo AR; Center for Epidemiologic Research, Brown University, Providence, Rhode Island, USA.
Open Forum Infect Dis ; 9(12): ofac634, 2022 Dec.
Article in En | MEDLINE | ID: mdl-36540392
ABSTRACT

Background:

Disparities in influenza vaccination exist between Hispanic and non-Hispanic White US nursing home (NH) residents, but the geographic areas with the largest disparities remain unknown. We examined how these racial/ethnic disparities differ across states and hospital referral regions (HRRs).

Methods:

This retrospective cohort study included >14 million short-stay and long-stay US NH resident-seasons over 7 influenza seasons from October 1, 2011, to March 31, 2018, where residents could contribute to 1 or more seasons. Residents were aged ≥65 years and enrolled in Medicare fee-for-service. We used the Medicare Beneficiary Summary File to ascertain race/ethnicity and Minimum Data Set assessments for influenza vaccination. We calculated age- and sex-standardized percentage point (pp) differences in the proportions vaccinated between non-Hispanic White and Hispanic (any race) resident-seasons. Positive pp differences were considered disparities, where the proportion of non-Hispanic White residents vaccinated was greater than the proportion of Hispanic residents vaccinated. States and HRRs with ≥100 resident-seasons per age-sex stratum per racial/ethnic group were included in analyses.

Results:

Among 7 442 241 short-stay resident-seasons (94.1% non-Hispanic White, 5.9% Hispanic), the median standardized disparities in influenza vaccination were 4.3 pp (minimum, maximum 0.3, 19.2; n = 22 states) and 2.8 pp (minimum, maximum -3.6, 10.3; n = 49 HRRs). Among 6 758 616 long-stay resident-seasons (93.7% non-Hispanic White, 6.5% Hispanic), the median standardized differences were -0.1 pp (minimum, maximum -4.1, 11.4; n = 18 states) and -1.8 pp (minimum, maximum -6.5, 7.6; n = 34 HRRs).

Conclusions:

Wide geographic variation in influenza vaccination disparities existed across US states and HRRs. Localized interventions targeted toward areas with high disparities may be a more effective strategy to promote health equity than one-size-fits-all national interventions.
Key words

Full text: 1 Collection: 01-internacional Health context: 1_ASSA2030 Database: MEDLINE Type of study: Observational_studies Language: En Journal: Open Forum Infect Dis Year: 2022 Document type: Article

Full text: 1 Collection: 01-internacional Health context: 1_ASSA2030 Database: MEDLINE Type of study: Observational_studies Language: En Journal: Open Forum Infect Dis Year: 2022 Document type: Article