2170. The National Burden of Pneumonia and Influenza in U.S. Nursing Homes, 2013-2015.
Session: Poster Abstract Session: Healthcare Epidemiology: HAI Surveillance
Saturday, October 6, 2018
Room: S Poster Hall
Background: National data on pneumonia & influenza (P&I) morbidity is lacking for the U.S. nursing home (NH) population. Our primary objective was to determine the incidence of hospitalization due to P&I.

Methods: This retrospective cohort used nursing home Minimum Data Set clinical assessments and Medicare claims for U.S. nursing home residents. Any resident who stayed in a nursing home from 01/01/2013 through 12/31/2015 was included and classified as short-stay or long-stay (≥100 days in the home). Residents <65 years old or enrolled in a HMO plan were excluded. Hospitalizations due to P&I were identified in the first position on Part A claims (ICD9 diagnoses 480.xx-488.xx). Outcomes were reported for 2013-2014, to allow one-year forward evaluation.

Results: The study cohort comprised 4.2 million NH residents with 2.9 (69%) million short stays. Mean age (SD) was 80.5 (8.4) for short-stays versus 83.0 (8.5) years for long-stays. Long-stay residents were more likely to be female (66.3% vs. 60.4%), African-American (10.9% vs. 6.6%) and Hispanic (4.1% vs. 2.8%). For long-stay residents, 23.7% had documented coronary artery disease, 23.2% congestive heart failure, 33.2% diabetes and 47.9% dementia. Incidence proportions are reported in Table 1. Short-stay and long-stay residents have a similar risk of hospitalization due to P&I at one year (4.1% vs. 4.5%).

Conclusion: The national incidence of one-year P&I hospitalization was 4.1% and 4.5% among short-stay and long-stay NH residents. Vaccination, prompt diagnosis and treatment, hand-washing and environmental cleaning are all important interventions which can further reduce the morbidity of this disease.

Table 1. Incidence of P&I hospitalizations in Nursing Homes, 2013-2014

Short-stay residents

(n=1,790,388)

Long-stay residents

(n=873,254)

30-day

19,122 (1.1%)

4,656 (0.5%)

180-day

50,433 (2.8%)

22,156 (2.5%)

365-day

72,948 (4.1%)

39,355 (4.5%)

Kevin Mcconeghy, Pharm.D.1,2, Andrew Zullo, PharmD, M.Sc., Ph.D.1,2, Robertus Van Aalst, M.Sc.3, Ayman Chit, Ph.D., MBiotech3, Stefan Gravenstein, MD, MPH1,2 and Vincent Mor, PhD1,2, (1)Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, (2)Long Term Services and Supports-COIN, Providence VA Medical Center, Providence, RI, (3)Sanofi-Pasteur, Swiftwater, PA

Disclosures:

K. Mcconeghy, Sanofi-Pasteur: Collaborator , Research support .

A. Zullo, Sanofi-Pasteur: Collaborator , Research grant .

R. Van Aalst, Sanofi-Pasteur: Employee , Salary .

A. Chit, Sanofi-Pasteur: Employee , Salary .

S. Gravenstein, Sanofi-Pasteur: Grant Investigator , Grant recipient , Research grant and Research support . Sequiris: Grant Investigator , Grant recipient , Research grant and Research support .

V. Mor, Sanofi-Pasteur: Grant Investigator , Grant recipient , Research grant and Research support . Sequiris: Grant Investigator and Investigator , Grant recipient , Research grant and Research support .

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