Influenza Vaccination Coverage Among Medicare Fee-for-Service Beneficiaries.

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Influenza vaccination is crucial for preventing influenza infection.
• Accurate measurement of influenza vaccination coverage is essential for public health surveillance.
• Discrepancies between self-reported and claims-based data can impact coverage estimates.

Purpose of the Study:

• To assess the concordance between self-reported and claims-based influenza vaccination coverage.
• To examine disparities in influenza vaccination among US beneficiaries.
• To evaluate the accuracy of self-reported vaccination data compared to claims.

Main Methods:

• Analysis of 2016-2019 Medicare Current Beneficiary Survey data linked to vaccination claims.
• Inclusion of beneficiaries aged ≥65 years in Medicare fee-for-service plans.
• Calculation of sensitivity, specificity, kappa statistics, and net bias; logistic regressions for disparity analysis.

Main Results:

• Survey-based coverage (76.3%) was higher than claims-based coverage (60.0%), with a net bias of 16.3 percentage points.
• Self-reported data showed high sensitivity (98.7%) but moderate specificity (57.4%).
• Higher net bias and lower data agreement were observed in males, racial/ethnic minorities, and rural residents.

Conclusions:

• Data agreement between self-reported and claims-based influenza vaccination varies significantly across demographic groups.
• Self-reported data may overestimate coverage, particularly among males, minorities, and rural populations.
• Claims data may underestimate influenza vaccination rates, potentially masking true disparities.