Andrea Gruneir1, Jeff C Kwong, Michael A Campitelli, Alice Newman, Geoffrey M Anderson, Paula A Rochon, Vincent Mor. 1. Andrea Gruneir and Paula A. Rochon are with the Women's College Research Institute, Women's College Hospital, Toronto, ON. Jeff C. Kwong, Michael A. Campitelli, and Alice Newman are with the Institute for Clinical Evaluative Sciences, Toronto. Geoffrey M. Anderson is with the Institute of Health Policy, Management, and Evaluation, University of Toronto. Vincent Mor is with the Department of Health Services, Policy and Practice, Brown University, Providence, RI.
Abstract
OBJECTIVES: We compared seasonal influenza hospital use among older adults in long-term care (LTC) and community settings. METHODS: We used provincial administrative data from Ontario to identify all emergency department (ED) visits and hospital admissions for pneumonia and influenza among adults older than 65 years between 2002 and 2008. We used sentinel laboratory reports to define influenza and summer seasons and estimated mean annual event rates and influenza-associated rates. RESULTS: Mean annual pneumonia and influenza ED visit rates were higher in LTC than the community (rate ratio [RR] for influenza season = 3.9; 95% confidence interval [CI] = 3.8, 4.0; for summer = 4.9; 95% CI = 4.8, 5.1) but this was attenuated in influenza-associated rates (RR = 2.4; 95% CI = 2.1, 2.8). The proportion of pneumonia and influenza ED visits attributable to seasonal influenza was 17% (15%-20%) in LTC and 28% (27%-29%) in the community. Results for hospital admissions were comparable. CONCLUSIONS: We found high rates of hospital use from LTC but evidence of lower impact of circulating influenza in the community. This differential impact of circulating influenza between the 2 environments may result from different influenza control policies.
OBJECTIVES: We compared seasonal influenza hospital use among older adults in long-term care (LTC) and community settings. METHODS: We used provincial administrative data from Ontario to identify all emergency department (ED) visits and hospital admissions for pneumonia and influenza among adults older than 65 years between 2002 and 2008. We used sentinel laboratory reports to define influenza and summer seasons and estimated mean annual event rates and influenza-associated rates. RESULTS: Mean annual pneumonia and influenza ED visit rates were higher in LTC than the community (rate ratio [RR] for influenza season = 3.9; 95% confidence interval [CI] = 3.8, 4.0; for summer = 4.9; 95% CI = 4.8, 5.1) but this was attenuated in influenza-associated rates (RR = 2.4; 95% CI = 2.1, 2.8). The proportion of pneumonia and influenza ED visits attributable to seasonal influenza was 17% (15%-20%) in LTC and 28% (27%-29%) in the community. Results for hospital admissions were comparable. CONCLUSIONS: We found high rates of hospital use from LTC but evidence of lower impact of circulating influenza in the community. This differential impact of circulating influenza between the 2 environments may result from different influenza control policies.
Authors: Mark Loeb; Soo Chan Carusone; Ron Goeree; Stephen D Walter; Kevin Brazil; Paul Krueger; Andrew Simor; Lorraine Moss; Thomas Marrie Journal: JAMA Date: 2006-06-07 Impact factor: 56.272
Authors: Lisa R Shugarman; Craig Hales; Claude Messan Setodji; Barbara Bardenheier; Joanne Lynn Journal: J Am Med Dir Assoc Date: 2006-09-26 Impact factor: 4.669
Authors: William W Thompson; David K Shay; Eric Weintraub; Lynnette Brammer; Nancy Cox; Larry J Anderson; Keiji Fukuda Journal: JAMA Date: 2003-01-08 Impact factor: 56.272
Authors: William W Thompson; David K Shay; Eric Weintraub; Lynnette Brammer; Carolyn B Bridges; Nancy J Cox; Keiji Fukuda Journal: JAMA Date: 2004-09-15 Impact factor: 56.272
Authors: Shelley E Ellis; Christopher S Coffey; Edward F Mitchel; Robert S Dittus; Marie R Griffin Journal: J Am Geriatr Soc Date: 2003-06 Impact factor: 5.562