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Disparity between Influenza Vaccination Rates and Risks for Influenza-associated Hospital Discharge and Death in Manitoba in 1982-1983

David S. Fedson, MD; Andre Wajda, MSC; J. Patrick Nicol, BComm; and Leslie L. Roos, PhD
[+] Article, Author, and Disclosure Information

Grant Support: By National Institutes of Health 5-R01 AG 09145; the Manitoba Centre for Health Policy and Evaluation; Career Scientist Award 6607-1314-48 (Dr. Roos); and the Canadian Institute for Advanced Research.

Requests for Reprints: David S. Fedson, MD, Box 494, University of Virginia Medical Center, Charlottesville, VA 22908.

Current Author Addresses: Dr. Fedson: Box 494, University of Virginia Medical Center, Charlottesville, VA 22908.

Mr. Wajda, Mr. Nicol, and Dr. Roos: Manitoba Centre for Health Policy and Evaluation, St. Boniface General Hospital Research Centre, 351 Tache Avenue, Winnipeg, Manitoba, Canada R2H 2A6.

© 1992 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1992;116(7):550-555. doi:10.7326/0003-4819-116-7-550
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Objective: To determine, in a defined population, the percentage of persons who were discharged from a hospital or died of influenza-associated respiratory conditions who had a health care contact during the preceding vaccination season and to determine the relation between risk status for influenza-associated hospitalization and death and influenza vaccination rates.

Design: An observational study using linked-record analysis of medical claims data.

Setting and Patients: A probability sample of 100 000 noninstitutionalized adults living in Manitoba in 1982 to 1983.

Measurements: Analysis of medical claims for influenza vaccination and hospital discharges and deaths for influenza-associated respiratory conditions during the 1982-83 influenza vaccination season and influenza outbreak period.

Results: For the population as a whole, 50% to 60% of elderly persons (≥ 65 years of age) and 30% to 40% of younger persons had one or more health care contacts during the influenza vaccination season but fewer than 10% of all persons had been discharged from a hospital. In contrast, for elderly persons hospitalized with respiratory conditions during the influenza outbreak period, approximately 80% had at least one health care contact during the vaccination season. Among the elderly, 39% to 46% of all those discharged for influenza-associated respiratory conditions and 62% to 67% of those who died had been discharged from hospital during the previous vaccination season. Persons discharged with high-risk conditions during the vaccination season were at greater risk for hospitalization with influenza-associated respiratory conditions but were less likely to be vaccinated than were those at lower risk.

Conclusions: Most persons who were hospitalized with influenza-associated respiratory conditions had contact with health care providers during the preceding influenza vaccination season. Among elderly patients, previous hospital care was common, especially among those who died. The disparity between influenza vaccination rates and risks for influenza-associated hospital discharge and death supports a strategy of hospital-based influenza vaccination.





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