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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 Location

https://doi.org/10.1016/j.jamda.2019.06.025
No data is associated with this publication.
Abstract

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.

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This item is under embargo until September 13, 2020.