Pneumonia and Influenza Hospitalizations in Elderly People with Dementia

Naumova, Elena N.; Parisi, Sara M.; Castronovo, Denise; Pandita, Manisha; Wenger, Julia; Minihan, Paula M.

doi:10.1111/j.1532-5415.2009.02565.x

Cited by 39 publications

(26 citation statements)

References 30 publications

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“…For example, difficulties accessing qualified healthcare providers for elderly people, who are often at greatest risk of respiratory disease, can have severe consequences for the outcome of disease. Previous studies have demonstrated that accessibility to healthcare is a significant predictor of morbidity and mortality among elderly individuals with respiratory disease [34].…”

Section: Discussionmentioning

confidence: 99%

Evaluating Hospital-Based Surveillance for Outbreak Detection in Bangladesh: Analysis of Healthcare Utilization Data

et al. 2017

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BackgroundThe International Health Regulations outline core requirements to ensure the detection of public health threats of international concern. Assessing the capacity of surveillance systems to detect these threats is crucial for evaluating a country’s ability to meet these requirements.Methods and FindingsWe propose a framework to evaluate the sensitivity and representativeness of hospital-based surveillance and apply it to severe neurological infectious diseases and fatal respiratory infectious diseases in Bangladesh. We identified cases in selected communities within surveillance hospital catchment areas using key informant and house-to-house surveys and ascertained where cases had sought care. We estimated the probability of surveillance detecting different sized outbreaks by distance from the surveillance hospital and compared characteristics of cases identified in the community and cases attending surveillance hospitals.We estimated that surveillance detected 26% (95% CI 18%–33%) of severe neurological disease cases and 18% (95% CI 16%–21%) of fatal respiratory disease cases residing at 10 km distance from a surveillance hospital. Detection probabilities decreased markedly with distance. The probability of detecting small outbreaks (three cases) dropped below 50% at distances greater than 26 km for severe neurological disease and at distances greater than 7 km for fatal respiratory disease. Characteristics of cases attending surveillance hospitals were largely representative of all cases; however, neurological disease cases aged <5 y or from the lowest socioeconomic group and fatal respiratory disease cases aged ≥60 y were underrepresented.Our estimates of outbreak detection rely on suspected cases that attend a surveillance hospital receiving laboratory confirmation of disease and being reported to the surveillance system. The extent to which this occurs will depend on disease characteristics (e.g., severity and symptom specificity) and surveillance resources.ConclusionWe present a new approach to evaluating the sensitivity and representativeness of hospital-based surveillance, making it possible to predict its ability to detect emerging threats.

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Section: Discussionmentioning

confidence: 99%

Evaluating Hospital-Based Surveillance for Outbreak Detection in Bangladesh: Analysis of Healthcare Utilization Data

et al. 2017

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“…First, the unit of observation was the state; past research suggests that although states are someone homogeneous, a sizeable amount of heterogeneity exists within states with respect to the distribution of P&I rates and sociodemographic characteristics. 27 Second, the dominant circulating influenza virus strain and whether or not the proper vaccine for each influenza season was used were not considered. Effective matching of vaccine strains to the circulating strain could modulate the effectiveness of vaccinating older adults against P&I.…”

Section: Discussionmentioning

confidence: 99%

Influenza Vaccination in Young Children Reduces Influenza-Associated Hospitalizations in Older Adults, 2002-2006

Cohen

Chui

Naumova

2011

Journal of the American Geriatrics Society

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OBJECTIVES To assess how influenza vaccination coverage in children is related to pneumonia and influenza (P&I) in US seniors and if these associations are modified by sociodemographic factors. DESIGN We abstracted approximately 5 million hospitalization records from the Centers for Medicare and Medicaid Services for four influenza years, 2002–2006. We estimated a single year age distribution of rates of P&I hospitalization by state for each influenza season and observed an exponential acceleration in the P&I rates with age for each influenza season. State-and season-specific P&I rate accelerations were regressed against the percentage of vaccinated children, seniors, or both using mixed effects models. SETTING United States population, 2002–2006 PARTICIPANTS US population aged 65 and above MEASUREMENTS State-level influenza annual vaccination coverage data in children and seniors were obtained from the National Immunization Survey and the Behavioral Risk Factor Surveillance System, respectively. RESULTS Child influenza vaccination coverage was negatively associated with age acceleration in P&I, whereas influenza vaccination in the seniors themselves was not significantly associated with P&I in seniors. CONCLUSION Vaccination of children against influenza may induce herd immunity against influenza for seniors and has the potential to be more beneficial to seniors than the existing policy to prevent influenza by vaccinating seniors themselves.

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“…Prior studies on rural health disparities related to ADRD have focused largely on issues of access to care for patients diagnosed with dementia, and the research has shown that patients with dementia living in rural areas are more likely to receive suboptimal health care . Thorpe et al suggest that rural dementia patients may face barriers to effective ambulatory care and experience unnecessary hospitalizations .…”

mentioning

confidence: 99%

“…Thorpe et al suggest that rural dementia patients may face barriers to effective ambulatory care and experience unnecessary hospitalizations . Similarly, Naumova et al examined claims data from Centers for Medicare and Medicaid Services (CMS) between 1998 and 2002 and reported that while rural beneficiaries were more likely to be diagnosed with pneumonia and influenza overall, rural dementia patients were less likely to receive an influenza diagnosis, had shorter hospital stays associated with influenza, and were 50% more likely to die from influenza …”

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confidence: 99%

Rural‐Urban Differences in Alzheimer's Disease and Related Disorders Diagnostic Prevalence in Kentucky and West Virginia

Abner

Jicha

Christian

et al. 2015

The Journal of Rural Health

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Purpose Older adults living in rural areas may face barriers to obtaining a diagnosis of Alzheimer’s disease and related disorders (ADRD). We sought to examine rural-urban differences in prevalence of ADRD among Medicare beneficiaries in Kentucky and West Virginia, 2 geographically similar states with large rural areas and aged populations. Methods Centers for Medicaid and Medicare Services Public Use Files data from 2007 to 2013 were used to assess prevalence of ADRD at the county-level among all Medicare beneficiaries in each state. Rural-Urban Continuum Codes were used to classify counties as rural or urban. We used Poisson regression to estimate unadjusted and adjusted prevalence ratios. Primary analyses focused on 2013 data and were repeated for 2007 to 2012. This study was completely ecologic. Findings After adjusting for state, average beneficiary age, percent of female beneficiaries, percent of beneficiaries eligible for Medicaid in each county, Central Appalachian county, percent of residents ≥ age 65 enrolled in Medicare, and percent of residents < 65 enrolled in Medicare in our adjusted models, we found that 2013 diagnostic prevalence was 11% lower in rural counties (95% CI: 9%, 13%). Conclusions Medicare beneficiaries in rural counties in Kentucky and West Virginia may be underdiagnosed with respect to ADRD compared to other chronic disease conditions. However, due to the ecologic design, and evidence of a younger, more heavily male beneficiary population in some rural areas, further studies using individual-level data are needed to confirm the results

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Pneumonia and Influenza Hospitalizations in Elderly People with Dementia

Cited by 39 publications

References 30 publications

Evaluating Hospital-Based Surveillance for Outbreak Detection in Bangladesh: Analysis of Healthcare Utilization Data

Evaluating Hospital-Based Surveillance for Outbreak Detection in Bangladesh: Analysis of Healthcare Utilization Data

Influenza Vaccination in Young Children Reduces Influenza-Associated Hospitalizations in Older Adults, 2002-2006

Rural‐Urban Differences in Alzheimer's Disease and Related Disorders Diagnostic Prevalence in Kentucky and West Virginia

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