Geospatial Distribution of Racial Disparities in Influenza Vaccination in Nursing Homes.
Geospatial Distribution of Racial Disparities in Influenza Vaccination in Nursing Homes.
复制标题
疗养院流感疫苗接种种族差异的地理空间分布。
DOI：
10.1016/j.jamda.2023.08.018
复制
发表时间：
2023
影响因子：
7.6
通讯作者：
Zullo,AndrewR
中科院分区：
文献类型：
--
作者：
Silva,JoeBB;Howe,ChanelleJ;Jackson,JohnW;Bardenheier,BarbaraH;Riester,MelissaR;vanAalst,Robertus;Loiacono,MatthewM;Zullo,AndrewR
ObjectivesThis study aims to assess the distribution of racial disparities between白色and Black short-stay and long-stay nursing home residents among states and hospital referral regions（HRR）.DesignRetrospective cohort study. Settings and hippantsWe included short-stay and long-stay elderly adults residing in US nursing homes during influenza seasons between 2011 and 2018.纳入的居民年龄≥65岁，并参加了传统医疗保险。使用居民季节进行分析，居民可以贡献一个或多个流感季节，如果他们住在一个养老院在多个seasons.MethodsOur比较的利益被边缘化与特权种族群体成员的黑色与白色种族。我们从特定流感季节的10月1日至6月30日的居民最小数据集评估中获得了流感疫苗接种文件。非参数g-公式用于估计年龄和性别标准化的疫苗接种差异，测量为各州和HRR内黑人和白色疗养院居民之间接种疫苗的个体比例的百分点（pp）差异。在14，889家养老院中，有7，308，111名长期居住者（86.7%白色和13.3%黑人）。在各州中，黑人和白色居民之间的年龄和性别标准化差距中位数在短期居民中为10.1个百分点，在长期居民中为5.3个百分点。在HRR中，中位数差距为8.6之间的短期逗留的居民和5.0之间的长期逗留的居民跨越seasons. ConclusionsandImplicationsOur分析显示，疫苗接种差距的幅度变化很大，各州和HRR，从没有差距，在疫苗接种的差距超过25个百分点。地方干预措施和政策应针对高度不平等的地理区域，以增加疫苗接种和促进卫生公平。
ObjectivesThis study aimed to assess the distribution of racial disparities in influenza vaccination between White and Black short-stay and long-stay nursing home residents among states and hospital referral regions (HRRs).DesignRetrospective cohort study.Setting and ParticipantsWe included short-stay and long-stay older adults residing in US nursing homes during influenza seasons between 2011 and 2018. Included residents were aged ≥65 years and enrolled in Traditional Medicare. Analyses were conducted using resident-seasons, whereby residents could contribute to one or more influenza seasons if they resided in a nursing home across multiple seasons.MethodsOur comparison of interest was marginalized vs privileged racial group membership measured as Black vs White race. We obtained influenza vaccination documentation from resident Minimum Data Set assessments from October 1 through June 30 of a particular influenza season. Nonparametric g-formula was used to estimate age- and sex-standardized disparities in vaccination, measured as the percentage point (pp) difference in the proportions of individuals vaccinated between Black and White nursing home residents within states and HRRs.ResultsThe study included 7,807,187 short-stay resident-seasons (89.7% White and 10.3% Black) in 14,889 nursing homes and 7,308,111 long-stay resident-seasons (86.7% White and 13.3% Black) in 14,885 nursing homes. Among states, the median age- and sex-standardized disparity between Black and White residents was 10.1 percentage points (pps) among short-stay residents and 5.3 pps among long-stay residents across seasons. Among HRRs, the median disparity was 8.6 pps among short-stay residents and 5.0 pps among long-stay residents across seasons.Conclusions and ImplicationsOur analysis revealed that the magnitudes of vaccination disparities varied substantially across states and HRRs, from no disparity in vaccination to disparities in excess of 25 pps. Local interventions and policies should be targeted to high-disparity geographic areas to increase vaccine uptake and promote health equity.