title: Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics.
abstract: OBJECTIVE
  Nursing home (NH) employee influenza vaccination is associated with reductions in morbidity and mortality among residents. Little is known regarding associations between NH characteristics and employee influenza vaccination rates (EVRs). This study identifies NH characteristics that may be associated with EVRs.
  
  
  METHODS
  Data on employee vaccination rates and programs were gathered from the Office for Oregon Health Policy and Research reports for 3 influenza seasons from 2009 to 2012 and merged with Online Survey, Certification, and Reporting files, from which facility characteristics were obtained. Market controls were obtained from the 2010 Area Health Resource File. Multivariate linear and logistic regression were used to model relationships between facility characteristics and EVR per facility per year, whether formal education for employees was conducted, and whether 2010, 2015, and 2020 Healthy People targets were met.
  
  
  METHODS
  Oregon nursing homes from 2009 to 2012.
  
  
  METHODS
  NHs reporting sufficient data to calculate an EVR were included. Based on information obtained from 2009-2010, 2010-2011, and 2011-2012 surveys, EVRs were calculated for 113/140, 129/141, and 137/140 (81%, 91%, and 98% of) NHs, respectively.
  
  
  METHODS
  Dependent variables were EVR per facility per year, whether formal education for employees was conducted, and whether 2010, 2015, and 2020 Healthy People targets were met. Independent variables included facility characteristics and market controls.
  
  
  RESULTS
  On average, chain-affiliated NHs had 9% higher EVRs (P = .01) and 73% higher odds of achieving 60% EVR (2010 target, P = .05) than free-standing NHs. For-profit NHs had, on average, 8% lower EVRs (P = .04) than not-for-profit NHs. Surprisingly, a 10% increase in proportion of Medicaid residents was associated with a 2% increase in EVR (P = .01) and higher odds of achieving 60% (odds ratio = 1.20, P = .004) and 70% (2015 target, odds ratio = 1.14, P = .05) EVR.
  
  
  CONCLUSIONS
  Given that NHs generally have low employee influenza vaccination rates, it may be necessary to target low-performing facilities to achieve substantial improvements. However, significant correlates of this study cannot be easily addressed by NH management or policymakers. Without policy change encouraging key components of vaccination programs, public reporting may be insufficient to improve EVRs.
authors: Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, NY. Electronic address: Lauren_Campbell@urmc.rochester.edu.
authors: Lauren J
authors: LJ
authors: Campbell
authors: Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, NY.
authors: Qinghua
authors: Q
authors: Li
authors: Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, NY.
authors: Yue
authors: Y
authors: Li
mesh_terms: D000328:Adult; D005260:Female; D006282:Health Personnel; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D009735:Nursing Homes; D009922:Oregon
chemical_list: D007252:Influenza Vaccines
keywords: Nursing homes; healthcare worker; influenza; vaccination