- 學位論文
高齡者接種公費流感疫苗是否發生流行性感冒與後續之醫療利用分析
Analysis of Influenza Occurence in the Elderly Vaccinated with Public Influenza and Subsequent Health Care Utilization
摘要
目的 本研究乃針對台灣高齡 (65歲以上)之民眾接種公費流感疫苗與否，與流感疫情前、中、後之醫療利用狀況進行分析。目的在於觀察接種者之發病率及後續使用醫療資源及死亡率是否較未接種者為低。 方法 本研究是利用衛生福利部衛生福利資料科學中心的兩百萬人抽樣檔做為母體，於其中篩選出六十五歲以上高齡者為研究對象，藉由有無施打公費流感疫苗之健保紀錄，將研究對象分為研究組(接種者)與對照組(未接種者)，再依據其診斷代碼，探討接種公費流感疫苗是否能影響流行性感冒的發病率。同時也針對兩組民眾，在後續就醫治療的醫療利用與費用高低等數據進行分析。 結果 觀察各年度組別有關發病率之結果，在施打流感疫苗期間之前、期間及之後，對照組之流感發病人數皆比研究組低，可以認定研究組屬於流行性感冒的高危險群體，此外，在醫療利用與費用方面的觀察可以發現，研究組的門診次數無論是否在疫苗施打期間，均明顯高於對照組，在門診費用上亦然。但在急診次數、住院天數、以及死亡率上，研究組均較對照組為低。 結論 觀察接種公費流感疫苗之高齡(65歲以上)民眾與未接種之高齡民眾，其流行性感冒發病率及醫療利用與費用並未有較低之現象。然而有接種公費流感疫苗之高齡者(65歲以上)民眾在急診率、住院率以及死亡率，均明顯低於未接種者。研究結果可提供衛生主管機關擬定高齡接種流感疫苗政策之參考。
並列摘要
Objectives: This study aims to analyze the situation of elderly (age 65+) people in Taiwan receiving the vaccination against influenza, and to analyze the health care utilization before, during and after the flu epidemic. The purpose is to observe whether the incidence and the medical resources used by the vaccinator are lower than those of the unvaccinated. Methods: The matrix of this study is a two million people database from the Health and Welfare Data Science Center of MOHW (Ministry of Health and Welfare) in which those who are older than 65 years old were selected as the study subjects. The subjects were divided into 2 study groups – the research group (vaccinated) and control group (not vaccinated). According to the diagnostic code, the effect of influenza vaccine could be analyzed; on the other hand, the resource and cost used in the following medical process were also analyzed. Results: Observing the results of the morbidity rate in each annual group before and after the flu shot, the number of flu cases in the control group was lower than that of the study group; thus the study group could be considered as the high risk group for influenza. In addition, observations in health care utilization and costs found that the number of outpatient visits in the study group was significantly higher than that of the control group, regardless of the vaccine application period; the outpatient cost was also the same. However, in the number of emergency visits, hospital stays, and mortality, the study group was lower than the control group. Conclusion: Observing the elderly (over 65 years old) who received influenza vaccination, the incidence of influenza is not lower than that of the population of elderly who were not vaccinated. However, the situation of the research group (vaccinated) in the emergency visits, hospitalization rate and mortality rate were significantly lower than the control group (unvaccinated). Research results can be a reference for health authorities when enacting policies for the elderly’s influenza vaccination.
參考文獻
延伸閱讀
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