Louisiana Health Care Review
THE MEDICARE QUALITY IMPROVEMENT ORGANIZATION
Adult Immunization -
Influenza and Pneumococcal Vaccines
Preventive Services Improve Quality of Life
For Louisiana Medicare beneficiaries, the influenza vaccination rate is 30.6% (45th in the nation) and the pneumococcal vaccination rate is also 30.6% (again,  45th in the nation).
The Adult Immunization Project focuses on increasing rates of vaccination against influenza and pneumococcal disease for Medicare patients.

Public Health Importance
Pneumonia and influenza are the fifth leading causes of death in the United States in patients age 65 years and older.(1) Pneumonia accounts for nearly 600,000 Medicare patient hospitalizations utilizing more than 4.5 million inpatient days each year.(1,2) Pneumonia and influenza cause substantial morbidity and mortality for Medicare patients. 

In 1993, more than $3.5 billion was spent on inpatient care of Medicare patients with pneumonia.(3) Pneumonia also is the principal reason for more than 500,000 emergency department visits by Medicare patients each year.(2) The incidence of pneumonia increases with age, and more than 90 percent of deaths due to this condition are in the population aged 65 and older.(1,4,5)
  (View Footnotes)

Louisiana Data and Opportunity for Improvement
 Louisiana’s influenza vaccination ranks 45th in the nation, with a rate of 30.6% for Medicare beneficiaries. The pneumococcal vaccination for Medicare beneficiaries also ranks 45th in the nation with a rate, coincidentally, with a rate of 30.6%.

Despite the fact that influenza and pneumococcal vaccines are clinically effective,(6-28) cost effective,(6,9,11,12,26,28,29) and are Medicare Part B covered benefits,(30) they remain underutilized.(31-33)

According to the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey, the rate of influenza vaccination among Americans age 65 and older was 64.9 percent and the rate of pneumococcal polysaccharide vaccination was 60.0 percent. Coverage rates for certain racial and ethnic groups remain substantially below the general population. African-American beneficiaries had influenza vaccination rates that were approximately 20 percent below Caucasian Medicare patients.(31) Healthy People 2010 target rates are 90 percent for influenza and pneumococcal vaccination for adults aged 65 years and older as measured by the National Health Interview Survey.(32)

Opportunities to vaccinate Medicare inpatients are often missed.(33,34) Recommendations for adult immunization with influenza and pneumococcal vaccines have been published by the Advisory  Committee on Immunization Practices (ACIP).(35,36) Strategies for immunization that include the recommendation for vaccination of outpatients and inpatients prior to hospital discharge have been previously published.(35-44)  (View Footnotes)
CMS Measure Specifications for Adult Immunizations

Quality Measures

Criterion Met or Acceptable Alternative

1. Statewide influenza vaccination rate

Reported received influenza vaccine during current influenza season as measured by CAHPS

2. Statewide pneumococcal vaccination rate

Reported received pneumococcal vaccine as measured by CAHPS

Increase Adult Immunization Rates in Your Clinic
Go to Preparing for Flu Season for a quick guide to setting up flu clinics and getting your patients ready for the flu season.

Adult Immunization Web Site Links
Here is a list of informative Web sites related to Adult Immunizations.

 


For more Quality Improvement
resources, visit www.medqic.org

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