TY - JOUR
T1 - Racial/Ethnic Differences in Receipt of Influenza and Pneumococcal Vaccination among Long-Stay Nursing Home Residents
AU - Travers, Jasmine L.
AU - Dick, Andrew W.
AU - Stone, Patricia W.
N1 - Funding Information:
ducted, JLTwas supported by an award from the National Institute of Nursing Research [NINR; R01NR013687 to PWS]; and the Jonas Center for Nursing and Veterans Healthcare. JLT is currently supported by an award from the National Institute of Nursing Research (5 T32 NR009356-07 to MDN). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Jonas Center for Nursing and Veterans Healthcare. Disclosures: None. Disclaimer: None.
Publisher Copyright:
© Health Research and Educational Trust
PY - 2018/8
Y1 - 2018/8
N2 - Objective/Study Question: To examine racial/ethnic differences in influenza and pneumococcal vaccination receipt and nonreceipt among nursing home (NH) residents post implementation of federal vaccination policy. Data Sources/Study Setting/Study Design/Data Collection/Extraction Methods: An analysis of a merged national cross-sectional dataset containing resident assessment, facility, and community data for years 2010–2013 was conducted. Logistic regressions omitting and including facility fixed effects were used to examine the influence of race and ethnicity (black, Hispanic, white) and black concentration on vaccination status across and within NHs. Principle Findings: Vaccination receipt of 107,874 residents in 742 NHs was examined. Blacks were less likely than whites to receive influenza and pneumococcal vaccinations (OR = 0.75; OR = 0.81, respectively, p-values <.001). The likelihood of not being offered the influenza vaccination was greater for blacks (OR=1.25, p =.004) and the likelihood of not being offered the pneumococcal vaccination was greater for Hispanics (OR = 1.65, p =.04) compared to whites. Fixed effects showed that within the same NH, Hispanics were more likely to receive both vaccinations compared to whites (OR=1.22, p =.004 (influenza); OR=1.34, p <.001 (pneumococcal)). Facilities highly concentrated with blacks accounted for large proportions of differences seen in vaccination receipt. Conclusions: Racial/ethnic differences remain despite policy changes. Focused strategies aimed at NH personnel and racially segregated NHs are critical to improving vaccination delivery and eliminating disparities in care.
AB - Objective/Study Question: To examine racial/ethnic differences in influenza and pneumococcal vaccination receipt and nonreceipt among nursing home (NH) residents post implementation of federal vaccination policy. Data Sources/Study Setting/Study Design/Data Collection/Extraction Methods: An analysis of a merged national cross-sectional dataset containing resident assessment, facility, and community data for years 2010–2013 was conducted. Logistic regressions omitting and including facility fixed effects were used to examine the influence of race and ethnicity (black, Hispanic, white) and black concentration on vaccination status across and within NHs. Principle Findings: Vaccination receipt of 107,874 residents in 742 NHs was examined. Blacks were less likely than whites to receive influenza and pneumococcal vaccinations (OR = 0.75; OR = 0.81, respectively, p-values <.001). The likelihood of not being offered the influenza vaccination was greater for blacks (OR=1.25, p =.004) and the likelihood of not being offered the pneumococcal vaccination was greater for Hispanics (OR = 1.65, p =.04) compared to whites. Fixed effects showed that within the same NH, Hispanics were more likely to receive both vaccinations compared to whites (OR=1.22, p =.004 (influenza); OR=1.34, p <.001 (pneumococcal)). Facilities highly concentrated with blacks accounted for large proportions of differences seen in vaccination receipt. Conclusions: Racial/ethnic differences remain despite policy changes. Focused strategies aimed at NH personnel and racially segregated NHs are critical to improving vaccination delivery and eliminating disparities in care.
KW - Vaccines
KW - disparities
KW - long-term care
KW - Nursing Homes/statistics & numerical data
KW - Cross-Sectional Studies
KW - United States
KW - Humans
KW - Male
KW - Ethnicity/statistics & numerical data
KW - Immunization Programs/legislation & jurisprudence
KW - Influenza Vaccines/administration & dosage
KW - Healthcare Disparities/ethnology
KW - Aged, 80 and over
KW - Pneumococcal Vaccines/administration & dosage
KW - Female
KW - Influenza, Human/prevention & control
KW - Aged
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U2 - 10.1111/1475-6773.12759
DO - 10.1111/1475-6773.12759
M3 - Article
C2 - 28857151
AN - SCOPUS:85028669162
VL - 53
SP - 2203
EP - 2226
JO - Health Services Research
JF - Health Services Research
SN - 0017-9124
IS - 4
ER -