Abstract
Background
We compared regional coverage rates of influenza vaccination (composition in 1999/00 was A/Sydney-like A/Beijing-like B/Yamanashi-like and in 2000/01 was A/Moscow A/New Caledonia B/Beijing) to the rates, cost, and mortality for communityacquired pneumonia.
Methods
We used the Pearson’s correlation coefficient to establish linear associations between variables derived from Alberta administrative data during the period April 1, 1999 to March 31, 2001.
Results
The influenza vaccination coverage rate for the 17 health regions varied between 30% to 80% (mean 70%) in Alberta seniors (n=298,473). The annual hospitalization and ambulatory community-acquired pneumonia attack rates were 2% and 6.5% per year respectively. There were strongly negative correlations between vaccination coverage rates and pneumonia rates requiring hospitalization (r1999=-0.59 and r2000=-0.79 with both p<0.05), total per capita physician and hospital costs for pneumonia (r1999=-0.57 and r2000=-0.79 with both p<0.01), community-diagnosed pneumonia rate (r1999=-0.39, p=0.12 and r2000=-0.70, p<0.01) and per capita in-hospital mortality for pneumonia (r1999=-0.30, p=0.24 and r2000=-0.57, p<0.05). Per capita costs, rates, and mortality were highest and influenza vaccinations rate lowest in the northern, remote health regions. The per capita vaccination cost (about $10) was small in relationship to the per capita cost of hospital care for pneumonia (about $100).
Conclusion
Regional under-utilization of preventive influenza vaccination in Alberta seniors is associated with increased utilization of health services for community-acquired pneumonia.
Résumé
Contexte
Nous avons comparé les taux de couverture régionale du vaccin antigrippal (composé en 1999–2000 de souches apparentées à A/Sydney, A/Beijing et B/Yamanashi et en 2000–2001 à A/Moscou, A/Nouvelle-Calédonie et B/Beijing) aux taux, au coût et à la mortalité de la pneumonie acquise dans la communauté.
Méthode
À partir des données administratives de l’Alberta (1er avril 1999 au 31 mars 2001), nous avons utilisé le coefficient de corrélation de Pearson pour établir des associations linéaires entre les variables.
Résultats
Le taux de couverture du vaccin antigrippal chez les aînés des 17 régions sanitaires de l’Alberta (n=298 473) variait de 30 % à 80 % (moyenne 70 %). Les taux annuels de pneumonie communautaire chez les patients hospitalisés et ambulatoires étaient de 2 % et de 6,5 %, respectivement. Nous avons constaté de fortes corrélations négatives entre les taux de couverture vaccinale et les taux de pneumonie nécessitant une hospitalisation (r1999=-0,59 et r2000=-0,79, p<0,05 dans les deux cas), les coûts totaux par habitant en services médicaux et hospitaliers de traitement de la pneumonie (r1999=-0,57 et r2000=-0,79, p<0,01 dans les deux cas), les taux de pneumonie diagnostiquée dans la communauté (r1999=-0,39, p=0,12, et r2000=-0,70, p<0,01) et la mortalité à l’hôpital, par habitant, due à la pneumonie (r1999=-0,30, p=0,24, et r2000=-0,57, p<0,05). Les coûts, les taux et la mortalité par habitant étaient les plus élevés, et les taux de vaccination antigrippale les plus faibles, dans les régions sanitaires éloignées (celles du nord de la province). Le coût de vaccination par habitant (environ 10 $) était faible par rapport au coût par habitant des soins hospitaliers aux malades atteints de pneumonie (environ 100 $).
Conclusion
La sous-utilisation régionale du vaccin antigrippal à titre préventif chez les aînés albertains est associée à une utilisation accrue des services de santé pour traiter la pneumonie communautaire.
Footnotes
Support: This work was partially supported by the Alberta Center for Health Service Utilization Research. The opinions and conclusions expressed in this paper are those of the authors and no endorsement by the Alberta Ministry of Health & Wellness and Capital Health is implied.
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