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A study aims to evaluate the effectiveness of the influenza vaccine among persons 65 years or older. The results conclude that the vaccine is effective in reducing significantly the need for hospitalization due to pneumonia or influenza.

Vaccination against influenza can lower the risk of death from any cause in elderly people by up to 50%, according to a study of about 300,000 people 65 years old and older. It also reduces the risk of hospitalization for heart disease, stroke, and pneumonia, as well as influenza. Only 60% of the elderly people in this study had been vaccinated against influenza.

Flu vaccines appear to provide health benefits and cost savings for low-risk healthy adults. Doctors studied the short-term effects of injecting a flu vaccine into 422 healthy, working, adult volunteers aged 18-64 (study group). They compared these effects in a similarly matched group of 424 volunteers injected with a placebo (control group). Over a 4-month flu season, the study group reported 25% fewer sore throats with an associated cough or fever as compared to the control group. The study group took 43% fewer days off work and sought medical attention 44% fewer times as a result of these illnesses as compared to the control group. The estimated total cost savings, including medical costs and lost wages, was $46.85 per vaccinated person. Both groups reported only mild side effects from the injections.

Hospitals with psychiatric and abuse treatment wards present the greatest dilemma to establishing nationwide smoke-free hospitals. Of 934 accredited hospitals surveyed, 313 had psychiatric beds. Only 134 (43%) had smoke-free psychiatric wards. Of 190 hospitals with inpatient substance abuse beds, only 66 (35%) were smoke-free in those wards. Hospitals that did not require smoke-free policies in psychiatric wards cited difficulty relating to enforcement, such patient management and negative treatment outcomes. Most hospitals surveyed (76%) were able to enforce smoking bans within a year. Having a person at the hospital dedicated to enforcing the no-smoking policy greatly improved the chances of success. The problem of compliance among psychiatric patients and the chemically dependent needs to be resolved before hospitals can be totally smoke-free. In 1992, the Joint Commission on Accreditation of Healthcare Organizations began requiring acute care accredited hospitals to prohibit smoking., Objective.--To determine the extent of compliance with the new Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standard requiring acute care hospitals to be smoke-free, and to identify predictors of adoption of smoke-free hospital policies. Design.--We conducted a survey of a national sample of acute care hospitals and developed a predictive model for implementation of smoke-free policies using multiple logistic regression. We examined numerous factors that might predict adoption of smoke-free policies, such as hospital characteristics, patient care services, and experience with smoke-free initiatives. Setting and Participants.--A systematic 20% sample of JCAHO-accredited hospitals in the United States (n=1278). Military, Department of Veterans Affairs, Indian Health Service, psychiatric, substance abuse treatment, and children's hospitals were excluded. Main Outcome Measure.--Compliance with the JCAHO standard. Results.--The response rate was 85%. Sixty-five percent of hospitals were in compliance with the standard 16 months after it was introduced. Factors that were independently and positively associated with implementation of smoke-free policies were administrative support (odds ratio [OR], 7.82; 95% confidence interval [CI], 2.05 to 29.65) and inpatient smoking cessation services (OR, 1.24; 95% CI, 1.02 to 1.52). Factors negatively associated with implementation of smoke-free policy were the number of psychiatric treatment beds (OR, 0.57; 95% CI, 0.41 to 0.81), number of substance abuse treatment beds (OR, 0.17; 95% CI, 0.11 to 0.26), and presence of an active task force to address smoking policy (OR, 0.56; 95% CI, 0.40 to 0.77). Conclusions.--The majority of acute care hospitals are in compliance with the JCAHO national smoke-free policy initiative. The standard is well accepted by most patients and employees. It is critical to address the challenges presented by special populations, such as psychiatry patients, to accomplish the goal of completely smoke-free hospitals. (JAMA. 1995; 274:491-494)