Hospital Influenza Admissions as a Harbinger for Nursing Home Influenza Cases.
- Author(s): McConeghy, Kevin W
- Huang, Susan S
- Miller, Loren G
- McKinnell, James A
- Shireman, Theresa I
- Mor, Vincent
- Gravenstein, Stefan
- et al.
Published Web Locationhttps://doi.org/10.1016/j.jamda.2019.06.025
OBJECTIVES:To determine temporal associations of local measures of influenza morbidity and mortality by the Centers for Disease Control and Prevention (CDC) with influenza hospitalizations in nursing home residents. DESIGN:Retrospective, longitudinal panel study. SETTING AND PARTICIPANTS:Long-stay nursing home residents, aged 65 years or older in 823 nursing homes from 2011 to 2015. MEASURES:CDC-reported rates of influenza and pneumonia mortality and laboratory-confirmed influenza hospitalizations. We compared the CDC measures to nursing home resident hospitalizations due to (1) all-cause, (2) a primary diagnosis of respiratory or circulatory illness, and (3) a primary diagnosis of pneumonia or influenza based on Medicare Part A Claims data. RESULTS:Our final sample included 273,743 unique residents in 819 nursing homes in 108 cities. National laboratory-confirmed influenza-associated hospitalizations for the group aged 65 and older occurred 0 to 1 week prior to nursing home resident influenza-related hospitalizations (Spearman ρ = 0.54). CDC-reported influenza hospitalizations occurred 3 weeks prior to CDC-reported influenza deaths (ρ = 0.59). Nursing home resident influenza hospitalizations occurred 2 weeks before local CDC-reported pneumonia and influenza deaths occurred (ρ = 0.44). CONCLUSIONS/IMPLICATIONS:Publicly reported CDC measures correlate well with nursing home hospitalizations for pneumonia and influenza. Rates of laboratory-confirmed influenza hospitalizations (as reported by the CDC) may be a useful surrogate for nursing home influenza outbreaks but should be considered along with local indicators of disease outbreaks. Early community signals could be clinically leveraged as a trigger for increased infection control measures in nursing homes.
Many UC-authored scholarly publications are freely available on this site because of the UC Academic Senate's Open Access Policy. Let us know how this access is important for you.