Billing data from the Health Care Financing Administration (HCFA) indicated
that the influenza immunization rates for dialysis patients in the United
States do not meet the goal of 60% set by Healthy People 2000, and fall sig
nificantly short of the goal of 90% of all Medicare beneficiaries as outlin
ed in Healthy People 2010. Influenza and pneumonia together are the sixth l
eading cause of death in the United States. Despite the known benefits of i
nfluenza vaccination in reducing morbidity and mortality, only 40% to 50% o
f high-risk patients are immunized. Although HCFA/Medicare billing data may
not provide the best measurement of actual practice, it is currently the o
nly measure available from any national source. The data suggest that there
is a need for improvement. Because the HCFA/Medicare rates were based only
on those immunizations for which Medicare was billed, End-Stage Renal Dise
ase Network 15 embarked on a project to determine a more accurate rate of i
mmunization within the Network based on information provided by the dialysi
s facilities. Influenza vaccination rates for the winter 1998 flu season ra
nged from 51.5% to 84.9% for the states in the Network; the rate for the wh
ole Network was 74.6%. The HCFA/Medicare billed influenza immunization rate
s were 26.5 to 45.6 percentage points lower. (C) 2000 by the National Kidne
y Foundation, Inc.