One-third of COPD patients get treatment in the ER or hospital for influenza, an analysis found.
RT’s Three Key Takeaways:
- Low Flu Vaccination Rates in High-Risk Patients: Only about one-third of patients with COPD or asthma are getting annual flu shots, leaving them vulnerable to severe complications like pneumonia and respiratory failure.
- Significant Cost Implications: The analysis shows COPD and asthma patients face nearly triple the treatment costs for flu-related illnesses compared to those without chronic conditions, often requiring costly ER visits or hospital admissions.
- Predictive AI Offers Intervention Opportunities: Cedar Gate’s AI models predict that nearly two-thirds of patients are unlikely to get vaccinated this flu season, providing healthcare organizations with insights to target outreach and improve vaccination rates.
An analysis from Cedar Gate Technologies reveals that only 34.7% of commercially insured patients diagnosed with chronic obstructive pulmonary disease (COPD) or asthma are receiving their annual flu shots, leaving them vulnerable to severe complications and higher treatment costs.
Data from the 2022-2023 flu season shows that, despite the well-known risks, these high-risk patients “skip vaccination at alarming rates,” which can result in more emergency room visits and hospital admissions.
Low vaccination rates increase the risk of adverse outcomes for patients with one or more chronic diseases. Influenza infection in patients with COPD has been linked to risks of pneumonia, respiratory failure, and ischemic stroke. Asthma patients who get the flu are at higher risk of inflammation, narrowing airways, and pneumonia.
Cedar Gate’s analysis also found that the per-event cost for treatment of flu-related illness was almost three times higher for COPD and asthma patients at $952.01, compared to average costs for someone without either chronic health condition at $359.52 per event.
Higher costs are correlated with where patients seek treatment for flu-related illness:
- Nearly one-third of COPD patients (32.6%) went to the emergency room or were admitted for hospital inpatient care for influenza.
- That is four times higher than the 8% of patients without either chronic condition who went to the ER or hospital for flu-related care.
- Over 85% of flu treatments for people without a COPD or asthma diagnosis took place in a lower-cost setting, such as a doctor’s office, urgent care center, or telehealth appointment.
Of the members in Cedar Gate’s National Healthcare Benchmark Database with a COPD diagnosis, just 35.5% received a flu shot, and only 34.5% of members with an asthma diagnosis got vaccinated for the flu. Overall, about 3 in 10 eligible patients (29.16%) received a flu shot the same year, based on pharmacy claims data.
Predictive AI To Determine Influenza Vaccine Rates
Cedar Gate uses predictive artificial intelligence (AI) models to determine whether someone is likely to get an influenza vaccine. The AI model revealed that nearly two-thirds (65.5%) of all members in the database are unlikely to get a flu shot this year.
“As flu season approaches, predictive data from Cedar Gate’s analytics tools can help healthcare organizations identify patients at higher risk of complications from the flu and develop outreach strategies to prevent or reduce the severity of the illness,” says Dee Ann Bialecki-Haase, MD, vice president, senior medical officer at Medical Mutual, in a release. “Giving payers, providers, and employers data that helps them intervene sooner and take preventive measures can improve patient outcomes and lower the total cost of care.”
Flu vaccines are one of the most effective ways to prevent seasonal flu, according to the Centers for Disease Control and Prevention (CDC). However, the CDC estimates that less than half of people in the U.S. eligible for a flu vaccine actually get one, and the number is declining.
Those estimates are based on respondents’ answers to survey questions and may not capture the full picture of how many people skip flu vaccines each year.
Cedar Gate’s National Healthcare Benchmark Database includes claims data for approximately 15 million commercially insured members. Payers, providers, and self-funded employers use the database to benchmark performance, uncover trends within their own populations, and identify actionable steps to improve care and outcomes. All the information in the database is anonymized and thoroughly de-identified to protect patient privacy.
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