295 – Novel Applications of Statistics to Health Policy
Risk Factors of Hospital Readmission: Flu Vaccination of Health Care Workers, Comorbid Illness, and Socioeconomic Status
Maria Suprun
Icahn School of Medicine at Mount Sinai
Ronald B. Low
HHC
Shunsuke Ito
New York City Health and Hospitals Corporation
Raymond Gregory
HHC
Van Dunn
New York City Health and Hospitals Corporation
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