You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT JAMA
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 264 No. 9, September 5, 1990 TABLE OF CONTENTS
  JAMA
  •  Online Features
  Original Contributions
 This Article
 •References
 •Full text PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on Web of Science (65)
 •Contact me when this article is cited
 Related Content
 •Similar articles in JAMA
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit Add to Technorati Add to Twitter What's this?

Hospital-Based Pneumococcal Immunization

Epidemiologic Rationale From the Shenandoah Study

David S. Fedson, MD; Mary P. Harward, MD; Robert A. Reid, MD; Donald L. Kaiser, DrPH

JAMA. 1990;264(9):1117-1122.


Abstract

To explore the potential usefulness of a strategy of hospital-based pneumococcal immunization, we studied a population-based linked record of hospital discharges for Medicare enrollees living in the Shenandoah region of Virginia. A retrospective study of 1633 persons discharged with pneumonia in 1983 showed that 61% to 62% had been discharged within the previous 4 years. Among these patients, 87% had had one or more high-risk conditions recognized during previous hospital admissions. A cohort study demonstrated that discharged patients had a 6% to 9% probability of readmission with pneumonia within 5 years. Each such readmission could be prevented by immunizing few (approximately 100) discharged patients with pneumococcal vaccine. Furthermore, the costs of vaccination would be approximately one-third the costs of hospital care for unvaccinated discharged patients readmitted with pneumonia. These results provide an epidemiologic rationale for current recommendations that elderly patients discharged from hospitals should be immunized with pneumococcal vaccine.

(JAMA. 1990;264:1117-1122)



Author Affiliations

From the Department of Medicine, University of Virginia School of Medicine, Charlottesville.


Footnotes

Reprint requests to Box 494, University of Virginia Health Sciences Center, Charlottesville, VA 22908 (Dr Fedson).



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Severe Pneumonia
Niederman
ACCP Crit Care Med Brd Rev 2009;20:485-506.
FULL TEXT  

A case for immunization against nosocomial infections
Cross et al.
J. Leukoc. Biol. 2008;83:483-488.
ABSTRACT | FULL TEXT  

Influenza and Pneumococcal Immunization in Diabetes
Diabetes Care 2004;27:s111-113.
FULL TEXT  

Immunization and the Prevention of Influenza and Pneumococcal Disease in People With Diabetes
Diabetes Care 2003;26:s126-128.
FULL TEXT  

Failure to Vaccinate Medicare Inpatients: A Missed Opportunity
Bratzler et al.
Arch Intern Med 2002;162:2349-2356.
ABSTRACT | FULL TEXT  

Quality Indicators for the Management of Pneumonia in Vulnerable Elders
Rhew
ANN INTERN MED 2001;135:736-743.
FULL TEXT  

A Computerized Reminder System to Increase the Use of Preventive Care for Hospitalized Patients
Dexter et al.
NEJM 2001;345:965-970.
ABSTRACT | FULL TEXT  

Guidelines for the Management of Adults with Community-acquired Pneumonia . Diagnosis, Assessment of Severity, Antimicrobial Therapy, and Prevention
Niederman et al.
Am. J. Respir. Crit. Care Med. 2001;163:1730-1754.
FULL TEXT  

Smoking and Pneumococcal Infection
Sheffield and Root
NEJM 2000;342:732-734.
FULL TEXT  

Prognosis After Community-Acquired Pneumonia in the Elderly: A Population-Based 12-Year Follow-up Study
Koivula et al.
Arch Intern Med 1999;159:1550-1555.
ABSTRACT | FULL TEXT  

A Hospital-Based Pharmacy Intervention Program for Pneumococcal Vaccination
Vondracek et al.
Arch Intern Med 1998;158:1543-1547.
ABSTRACT | FULL TEXT  

Cost-effectiveness of Vaccination Against Pneumococcal Bacteremia Among Elderly People
Sisk et al.
JAMA 1997;278:1333-1339.
ABSTRACT  

Pneumococcal Vaccine After 15 Years of Use: Another View
Fedson et al.
Arch Intern Med 1994;154:2531-2535.
ABSTRACT  

Prevention of Respiratory Infections in Adults: Influenza and Pneumococcal Vaccines
Fiebach and Beckett
Arch Intern Med 1994;154:2545-2557.
ABSTRACT  

Antibody Response to Pneumococcal Vaccine in Middle-aged and Elderly Patients Recently Treated for Pneumonia
Hedlund et al.
Arch Intern Med 1994;154:1961-1965.
ABSTRACT  

Immunization of Adults
Gardner and Schaffner
NEJM 1993;328:1252-1258.
FULL TEXT  

Disparity between Influenza Vaccination Rates and Risks for Influenza-associated Hospital Discharge and Death in Manitoba in 1982-1983
Fedson et al.
ANN INTERN MED 1992;116:550-555.
ABSTRACT  

Pneumococcal Vaccine-Reply
Gable et al.
JAMA 1991;265:2194-2194.
ABSTRACT  

Pneumococcal Vaccination: When in Doubt, Go Ahead
Temianka
JAMA 1991;265:211-211.
ABSTRACT  

Pneumococcal Immunization: From Policy to Practice
Schwartz and Breiman
JAMA 1990;264:1154-1155.
ABSTRACT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1990 American Medical Association. All Rights Reserved.