Objective: Although many studies have shown the usefulness of influenza vaccine in elderly in-patients, the efficacy of vaccination with regard to the daily physical activities of patients has not been fully evaluated. To address this issue, we correlated the use of medical resources with vaccination status in patients categorized according to their daily activity levels. Methods: The subjects comprised 237 in-patients at or above 51 years of age, who were hospitalized in the long-term care unit of a Japanese hospital between January and March, 1999. The vaccination status and medical resources use (i.e., oral antibiotics, injected antibiotics, blood cell count, chest X-ray) of each patient were recorded, and the patients were assigned to three subgroups, based on daily life activity scores. Results: Vaccinated in-patients in the 'bed-bound' category required fewer medical resources, i.e., oral antibiotics (-2.29 days, P<0.05), injected antibiotics (-5.02 days, P<0.001), blood cell counts (-4.66 times, P<0.001), and chest X-rays (-4.31 times, P<0.001), compared with unvaccinated in-patients. There were no significant differences in treatment parameters between vaccinated and unvaccinated patients in the 'partly limited' or 'no limitation' categories. Conclusions: It is suggested that influenza vaccination significantly reduces the need for medical treatment only among those in-patients who are the least physically active. Further studies are required to repli-cate these findings, and to elucidate the underlying reasons for this reduction.

Objective: Although many studies have shown the usefulness of influenza vaccine in elderly in-patients, the efficacy of vaccination with regard to the daily physical activities of patients has not been fully evaluated. To address this issue, we correlated the use of medical resources with vaccination status in patients categorized according to their daily activity levels.Methods: The subjects comprised 237 in-patients at or above 51 years of age, who were hospitalized in the long-term care unit of a Japanese hospital between January and March, 1999. The vaccination status and medical resources use (i.e., oral antibiotics, injected antibiotics, blood cell count, chest X-ray) of each patient were recorded, and the patients were assigned to three subgroups, based on daily life activity scores.Results: Vaccinated in-patients in the 'bed-bound' category required fewer medical resources, i.e., oral antibiotics (-2.29 days, P<0.05), injected antibiotics (-5.02 days, P<0.001), blood cell counts (-4.66 times, P<0.001), and chest X-rays (-4.31 times, P<0.001), compared with unvaccinated in-patients. There were no significant differences in treatment parameters between vaccinated and unvaccinated patients in the 'partly limited' or 'no limitation' categories.Conclusions: It is suggested that influenza vaccination significantly reduces the need for medical treatment only among those in-patients who are the least physically active. Further studies are required to replicate these findings, and to elucidate the underlying reasons for this reduction.

Influenza vaccine is recommended for the elderly, a high-risk group for influenza infection. Unlike in many developed countries, the rate of influenza vaccination is extremely low in Japan. One of the primary reasons for this low level of vaccination use may be insufficient study on the cost-effectiveness of influenza vaccination in Japan. We determined the cost of medical tests and medications for inpatients with influenza in a referred hospital. We compared the medical costs by (1) level of daily life activity, (2) presence of pneumonia, and (3) living/dead status, 9 months after the infection. In addition, we set up a control group of patients for comparison of their medical costs to those of the influenza patients. Mean costs were 37,279 (+/- 26,784) yen for patients, and 2,361 (+/- 4,893) yen for controls. Mean costs were 32,424 (+/- 30,935) yen for inpatients without limitations to activity, 44,075 (+/- 20,937) yen for bed-bound inpatients, 44,614 (+/- 28,609) yen for inpatients with pneumonia, 27,009 (+/- 22,783) yen for inpatients without pneumonia, 57,624 (+/- 21,041) yen for inpatients who died within 9 months of the onset of influenza, and 16,934 (+/- 11,920) yen for inpatients who were alive 9 month after influenza infection.