• Shubing Cai and Helena Temkin-Greener.
• Center for Gerontology and Health Care Research, The Warren Alpert Medical School, Brown University, Providence, RI 02912, USA. Shubing_Cai@brown.edu
• J Am Med Dir Assoc. 2011 Sep 1; 12 (7): 493-8.

ObjectivesTo examine trends of influenza vaccination in nursing homes before and after public reporting (objective-1), and to assess the effect of influenza vaccinations on hospitalization events (objective-2).Research DesignNursing Home Compare (NHC) database was used to obtain influenza vaccination rates during the 2005-2006, 2006-2007, and 2007-2008 flu seasons (objective-1). The 2005-2007 Minimum Data Set for New York State (NYS) was obtained and linked with the NHC data (objective-2).Settings And ParticipantsAll nursing homes in the United States were included in the analysis of objective-1. All eligible NYS nursing homes and their residents, during 2005-2006 and 2006-2007 flu seasons, were included in the analysis of objective-2.MeasurementsNursing home was the unit of analysis. Influenza vaccination rates in nursing homes over the 3 flu seasons were compared nationwide. A first-differenced model was fit to examine the relationship between facility vaccination rates and hospitalization rates in NYS.ResultsThere was an increase in influenza vaccination rates in nursing homes over the 3 flu seasons, but this increase was no greater than that among community-dwelling elderly. In NYS facilities with high baseline vaccination rates, the effect of vaccination on reducing hospitalizations was small. In NYS facilities with a low baseline rate, a 10.0% increase in vaccination rate for long-term care residents was correlated with a 6.2% decline in baseline hospitalization rates. However, a 10.0% increase in vaccination rate for short-term care residents was correlated with a 4.6% increase in baseline hospitalization rates.ConclusionsThere is no clear evidence that public reporting improves vaccination rates in nursing homes. The effects of vaccination on hospitalization events in nursing homes are mixed.Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

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