influenza vaccination;
hospitalization;
geriatric assessment;
MDS;
home care;
frail elderly;
D O I:
10.1016/j.jclinepi.2006.02.017
中图分类号:
R19 [保健组织与事业(卫生事业管理)];
学科分类号:
摘要:
Objective: The aim of the study is (1) to describe the prevalence of vaccination against influenza in older home care patients and (2) to investigate the protective effect of influenza vaccination for hospitalization events. Study Design and Setting: This is an observational study conducted in four large cohorts of elderly patients in home care during the 1998-1999, 1999-2000, 2000-2001, and 2001-2002 influenza seasons. We analyzed data from the Italian Silver Network Home Care project. A total of 2,201 patients were enrolled in the present study. The main outcome measures were prevalence of vaccination against influenza and the rate of hospitalization according to vaccination status and influenza season. Results: The rate of influenza vaccination was around 48% of the studied sample. During the follow-up including the peak of influenza and the total influenza season, 412 subjects (40%) were hospitalized among vaccinated compared to 610 subjects (59%) among not vaccinated (P < 0.001). After adjusting for age, gender, location of home care program, and all the variables significantly different between vaccinated and not-vaccinated subjects, vaccinated subjects were less likely to be hospitalized compared to not-vaccinated subjects (OR, 0.73; 95% CI 0.60-0.90). Conclusions: Vaccination against influenza has an important prognostic implication for frail geriatric patients living in the community. (c) 2006 Elsevier Inc. All rights reserved.