title: The impact of influenza-associated respiratory illnesses on hospitalizations, physician visits, emergency room visits, and mortality.
abstract: OBJECTIVE
  Although the increased risk of hospitalization and mortality during influenza seasons has been documented extensively, there is a relative paucity of research on the impact of influenza-related illnesses on other health care use indicators, such as physician use. The purpose of this study was to examine the impact of influenza-associated respiratory illnesses on the Winnipeg health care system, including hospitalizations, physician visits and emergency room visits. Their impact on mortality was also examined.
  
  
  METHODS
  Administrative data were used to track health care use and mortality over four influenza seasons (1995-96 to 1998-99). Excess health care use and deaths were calculated by subtracting rates during influenza seasons from those during weeks when influenza viruses were not circulating.
  
  
  RESULTS
  Significant excess hospitalization, physician visit, and emergency room visit rates emerged for influenza and pneumonia, acute respiratory diseases, and chronic lung disease, especially among children and adults aged 65 and over. Considerable excess mortality due to influenza and pneumonia and chronic lung disease among individuals aged 65 and over also emerged, particularly among nursing home residents.
  
  
  CONCLUSIONS
  Influenza-associated respiratory illnesses have a substantial impact on the health care system. Given the burden of illness among children during influenza seasons, the study further suggests that influenza vaccination might be considered for this age group.
authors.affiliation: University of Manitoba, Winnipeg, MB, Department of Community Health Sciences. vmenec@cpe.umanitoba.ca
authors.forename: Verena H
authors.initials: VH
authors.lastname: Menec
authors.forename: Charlyn
authors.initials: C
authors.lastname: Black
authors.forename: Leonard
authors.initials: L
authors.lastname: MacWilliam
authors.forename: Fred Y
authors.initials: FY
authors.lastname: Aoki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D014600:Utilization Review