Using MedPAR inpatient claims, we identified hospitalizations that occurred while individuals were residents of an LTCF. Hospitalizations were identified by the presence of an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code in the principal position on the claim.29 Cardiovascular hospitalizations (ICD-9-CM codes 390.XX-459.XX; ICD-10-CM codes I00.XX-I99.XX) and respiratory hospitalizations (ICD-9-CM codes 460XX-519.XX; ICD-10-CM codes J00.XX-J08.XX and J12.XX-J99.XX) were identified as cardiorespiratory events. We identified explicit hospitalizations for pneumonia and influenza (ICD-9-CM codes 480.XX-488.XX; ICD-10-CM codes J09.XX-J18.XX) and RSV (ICD-9-CM codes 079.6. 480.1 and 466.11; ICD-10-CM codes J121, J205, J210, and B974) in which the virus was directly named in the diagnosis associated with the ICD-9-CM or ICD-10-CM code (eg, “Pneumonia due to respiratory syncytial virus”). This identification was done to quantify the incidence of admissions specifically for influenza and RSV infections. We chose to group pneumonia and influenza because pneumonia is often preceded by influenza infection, and these infections are difficult to distinguish using claims data.23,30 We estimated the cardiorespiratory events attributable to influenza and RSV, which were defined as any cardiorespiratory hospitalizations other than the aforementioned explicit pneumonia and influenza and RSV hospitalizations.

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