人類乳突病毒疫苗之經濟價值

Economic Value of Human PapillomaVirus Vaccine

廖芷嫻(Chih-Hsien, Liao)

指導教授 ： 湯澡薰

臺北醫學大學/醫學院/醫學資訊研究所/碩士(2007年)

摘要

子宮頸癌是台灣女性最常發生的癌症之一，嚴重威脅我國婦女的健康；近年來隨著人類乳突病毒(Human PapillomaVirus, HPV)疫苗問世，疫苗接種儼然成為防治子宮頸癌的新選項之一。本研究嘗試以使用者觀點切入，目的在於瞭解一般婦女對HPV相關知識的認知、對子宮頸癌與HPV疫苗的態度，及HPV疫苗的經濟價值，進而推算用於避免因子宮頸癌身亡的統計生命價值(value of statistic life, VSL)。
資料蒐集是採用面訪調查，立意抽樣於台北市選取兩家教學醫院，以婦、產科門診之候診婦女為母群，尋找20-55歲且有女兒的婦女進行訪問，調查工作自民國九十六年三月中旬起，分為前測、實測及補查三階段，為期兩個月，共回收512份有效樣本。使用SAS 8.2版進行統計分析，以單因子變異數分析檢定影響HPV認知及態度的因素，再佐以存活分析法建構預測模型，分別推估HPV疫苗用於婦女本身或女兒的經濟價值。
研究結果發現四成以上的受訪者在本次調查前沒有聽過HPV；即便是有聽過HPV的婦女，在五個是非題中平均答對的題數僅有2.37題，其中更有80位完全不清楚相關訊息；顯示一般婦女對HPV的認識不足，特別在教育程度與家戶收入較低的族群，認知狀況相對弱勢。多數受訪者對HPV疫苗都抱持著正向態度，相信疫苗有效且安全，且態度受到認知的影響甚鉅。在疫苗具10年效期的假設下，婦女為自己接種HPV疫苗的經濟價值約為29,035-30,162元，用於女兒則為34,245-36,281元；若效期調整為20年，則經濟價值分別介於38,288-40,052元及48,147-50,759元。推算統計生命價值約為2,193-13,520萬台幣之間。
受訪婦女對於HPV的認知普遍不足，進而將影響其態度與接種意願(願付代價)，建議政策制定者或醫療提供者應設法提升相關衛生教育水平，以期婦女能夠瞭解HPV與子宮頸癌的關係，進而以預防HPV感染來收子宮頸癌防治之效。

關鍵字

人類乳突病毒 ； 子宮頸癌 ； 假設市場評價法 ； 認知、態度與行為模式

並列摘要

Objectives: Cervical cancer (CC) is the most common form of cancer among women in Taiwan. The human papillomavirus (HPV) vaccination have proved to be valuable in the prevention of HPV infection, and may thereby also help to prevent CC. This study is aimed at assessing women’s knowledge about HPV/CC, and the attitudes toward CC and HPV vaccination. Furthermore, the study applies the contingent valuation method (CVM) in order to elicit WTP among women for a hypothetical HPV vaccine capable of reducing the risk of infection from HPV and subsequent death from CC. Finally, value of statistic life (VSL) is conculated by WTP of HPV vaccine.
Methods: A total of 512 survey questionnaires were completed on women aged between 20 and 55 years who have daughters using the face-to face interview since March of 2007. One-way ANOVA and survival analyses will subsequently be employed to explore the determinants of knowledge/attitude about HPV/CC and the WTP of HPV vaccination among women.
Results: Initial results indicated that 42.1% of women have never heard of HPV. The average score of the five questions regarding the knowledge of HPV/CC is 2.37. After providing the information to the respondents during the interview on HPV and HPV vaccination, the acceptance and WTP was quite high. For a vaccination program with duration of 10 years, the average median WTP was NT$29,035-30,162 for the women themselves and NT$34,245-36,281 for their daughters. With duration of 20 years, the average median WTP was NT$38,288-40,052 for the women themselves and NT$48,147-50,759 for their daughters. VSL was high between NT$ 21.93 milloion to NT$ 13,520 million.
Conclusions: There is clearly a lack of knowledge about HPV/CC among interviewed women. In order to improve the understanding of, and compliance with, HPV testing and vaccination, policymakers should tailor their educational strategies towards targeted recipients.

並列關鍵字

Human PapillomaVirus ； cervical cancer ； contingent valuation method ； knowledge, attitude and practice model

參考文獻

行政院衛生署國民健康局。嘉喜疫苗仿單。http://203.65.100.151/DO8180.asp

行政院衛生署國民健康局。癌症登記年度報告。http://crs.cph.ntu.edu.tw/.

江明珠、曾瓊禎、蔡娟秀、郭漢崇(2004)。脊髓損傷患者對泌尿系統併發症的認知、態度及預防行為相關性之探討。慈濟護理雜誌，3(2)，59-67。

杜素珍、林玉芳、廖美南、林淑瓊、馬素華(2002)。護理人員對中醫藥的認知、態度和行為意向。台灣醫學，6(3)，320-331。

沈滿華、張玉婷、羅淑芬(2004)。原漢國中生性認知、態度、行為及性教育需求之探討。慈濟醫學，16(5)，325-334。