Risk Factors of Hospital Readmission: Flu Vaccination of Health Care Workers, Comorbid Illness, and Socioeconomic Status

• Activity Number: 295
• Type: Contributed
• Date/Time: Tuesday, August 5, 2014 : 8:30 AM to 10:20 AM
• Sponsor: Health Policy Statistics Section
• Author(s): Maria Suprun*+ and Shunsuke Ito and Raymond Gregory and Van Dunn and Ronald B. Low
• Companies: Icahn School of Medicine at Mount Sinai and HHC and HHC and HHC and HHC
• Keywords: readmission ; flu vaccination ; health care workers ; longitudinal data ; marginal model ; generalized estimating equations

Abstract

Vaccination of Health Care Workers (HCW) against influenza(flu) has been shown to protect nursing home patients; vaccination of all HCW is recommended by CDC. We examined the effect on readmission of HCW vaccination, comorbidity, and SES. Methods: From existing 2010-2013 QA reports of 2,242,598 NYC public hospital admissions, we developed a GEE models with logistic transformation for 30 day readmission. Explanatory variables included: flu vaccination rates, patient demographics, medical history, zip code proxy SES variables, national flu rates, and weather. QIC was used for model selection. Our model showed the following results (odds ratio/95% CI/increment for that OR (all p< .0001)): Protective factors: Female 0.64/0.62-0.66; English proficiency 0.95/0.94-0.96/*. GED 0.75/0.73-0.78/*. Main risk factors: Exposure to unvaccinated HCW in prior 2-14 days: 8.59/8.27-8.93/0-100% vaccination rate; Age 1.06/1.05-1.08/10yrs; National flu rate 1.57/1.39-1.79/1%; Asthma 1.8/1.7-1.9; CHF 1.4/1.4-1.5; Psychiatric disorder 1.58/1.53-1.63; Air temperature 1.5/1.46-1.54/10degC; Poverty level 1.39/1.31-1.47/*; *proxy variable from zip code, 10% increase