家長對幼童肺炎鏈球菌疫苗接種之健康信念與願付價值

Parents’ Health Belief to and Willingness-to-Pay for Pneumococcal Vaccination for Their Children

廖彩涵(Tsai-Han Liao)

指導教授 ： 楊銘欽

國立臺灣大學/公共衛生學院/健康政策與管理研究所/碩士(2011年)

https://doi.org/10.6342/NTU.2011.01233

摘要

研究背景與目的：台灣疾病管制局於2007年將侵襲性肺炎鏈球菌感染症(Invasive pneumococcal disease, IPD)納為第四類法定傳染病，世界衛生組織認為讓幼童接種肺炎鏈球菌疫苗是較有效預防IPD的介入方案。本研究的目的是探討家長對幼童肺炎鏈球菌疫苗接種之相關因素與願付價值(Willingness-to-pay, WTP)。
研究方法：研究對象為家中有五歲以下幼童之家長，且平時會於網路上搜尋相關醫療資訊者，調查時間為2011年4月20日至5月10日，透過網路問卷的調查方式蒐集有效樣本共566份。以卡方、威爾克森符號等級及克-瓦二氏單因子等級檢定雙因子相關，再以羅吉斯迴歸分析檢定影響家長是否讓小孩接種疫苗的相關因子，最後再以複迴歸分析檢定家長對疫苗的最大願付價值及相關影響因子。
研究結果：幼童肺炎鏈球菌疫苗的接種率約為68%；多數家長對疾病知識有一定程度的了解，但是對於疫苗效價和政府補助方案較不清楚；「疾病知識分數高」、「自覺行動利益高」、「自覺行動非金錢障礙低」、「自覺行動金錢障礙低」、「小孩滿一歲之後」、「家長年齡界於30至34歲」、「曾有醫療人員建議」或「曾看過院所宣傳單」者，較傾向讓小孩接種疫苗；「已讓小孩接種疫苗」或「自覺行動金錢障礙愈低」的家長，其願付價值愈高；家長對幼童肺炎鏈球菌疫苗之最大願付價值皆高於市售價格，其最大願付價值分界於台幣13,325 ~16,103元(幼童年齡0至6個月的家長)、8,576~12,670元(幼童年齡7至11個月的家長)、7,567~10,627元(幼童年齡12至23個月的家長)、2,711~3,128元(幼童年齡二至五歲的家長)。
結論與建議：針對本研究結果，建議衛生主管機關除可加強宣導疫苗方面的訊息，並且擬定相關補助辦法，提高醫療公帄性外，同時鼓勵醫療人員進行預防接種之衛生教育，藉以增加民眾對疫苗資訊的可近性。另一方面，建議未來的研究者可放入更多非醫療相關因素和假設情境之參數，再配合不同輔助工具的詢價方式，檢測家長對幼童肺炎鏈球菌疫苗之最大願付價值。

關鍵字

幼童肺炎鏈球菌疫苗 ； 健康信念模式 ； 最大願付價值

並列摘要

Background and objectives: Invasive pneumococcal disease (IPD) is one of the most commonly seen infectious diseases among children under five years old in Taiwan. This study aimed at analyzing parents’ health beliefs to and assessing willingness-to-pay for pneumococcal vaccination for their children.
Methods: A total of 566 web-based questionnaires were completed by parents who had children under five years old from April 20th to May 10th, 2011. Hypotheses were tested by using Chi-square, Wilcoxon rank sum test and Kruskal-Wallis test. Related factors which were associated with pneumococcal vaccination were examined by using logistic regression. The estimation of respondents’ willingness-to-pay for pneumococcal vaccination was calculated by using multiple linear regression.
Results: Study results indicate that 68% of respondents’ children were vaccinated against IPD. Most of the parents understood the knowledge of IPD but few of them realized the information about vaccination. The results showed that parents who understanding IPD more, perceiving more benefits and fewer barriers about vaccination, age between 30 and 34, being suggested by medical staff, seeing the information at hospital, or their children’s age > 1 year old tended to have their children vaccinated. In additon, parents who had let their children vaccinate or perceived lower monetary barriers would pay more for the vaccination. The amount of willingness-to-pay was NT$13,325-16,103 (for parents who had children under 6 months old), NT$8,576-12,670 (for parents who had children 7 to 11 months old), NT$7,567-10,627 (for parents who had children 12 to 23 months old) and NT$2,711-3,128 (for parents who had children 2 to 5 years old).
Conclusions: According to the results, the respondents were lacking information about vaccination. The competent authority could not only establish the reward systems to those in need but also motivate the physicians and nurses to educate the recipients. Future researchers could add more parameters along with different tools to aquire price to examine the willingness-to-pay of parents toward pneumococcal vaccination.

並列關鍵字

pneumococcal vaccination ； Health Belief Model ； Willingness-to-pay

參考文獻

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