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研究生:侯逸亭
研究生(外文):HOU,YI-TING
論文名稱:台灣地區幼童接種流感疫苗之效益分析
論文名稱(外文):Effectiveness Analysis of Influenza Vaccination for Children in Taiwan
指導教授:陳欽賢陳欽賢引用關係
指導教授(外文):CHEN,CHIN-SHYAN
學位類別:碩士
校院名稱:國立臺北大學
系所名稱:經濟學系
學門:社會及行為科學學門
學類:經濟學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:62
中文關鍵詞:幼童流感疫苗效益分析
外文關鍵詞:ChildrenInfluenza VaccinationEffectiveness Analysis
相關次數:
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自1998年開始政府首度度推動65歲以上高風險老人免費接種流感疫苗,2001年擴大至所有65歲以上老人, 2004年起又將六個月以上兩歲以下的幼兒納入免費接種名單。因幼童抵抗力較一般成人弱,且流感發生率為65歲以上老人的4~5倍,流感死亡率為65歲以上老人3~4倍,因流感而引起的重症併發症機率也比一般成年人高,所以幼童接種疫苗是很值得探討的議題。本研究利用「九十年度國民健康訪問調查資料」與「全民健保資料檔」,以2001年資料評估幼童自費接種流感疫苗的效益,檢視2004年的幼童免費接種政策是否有其必要性。
本研究將12歲以下的幼童共計3750個樣本,分為0~3歲與4~12歲兩部分別探討,兩部分樣本又分別分為接種疫苗與未接種疫苗兩組比較,並以門診機率、門診次數、門診費用、住院機率、住院次數及住院費用作為醫療利用的衡量指標,探討接種疫苗與這六個指標的關係。
研究結果發現,接種疫苗與醫療利用的相關變數上,大多數變數在迴歸分析中呈現不顯著或是顯著正相關,只有門診費用會因接種疫苗而呈現顯著地減少,但是從樣本分析中還是可以發現,接種疫苗可以降低門診次數、門診費用等醫療資源利用,尤其是醫療費用的部份。整體而言,對0~3歲的幼童接種流感疫苗,可以降低整個社會的醫療資源利用,對整個社會而言是具有效益。因此,本研究認為政府在2004年推動的幼童免費接種流感疫苗政策有其必要性,建議政府持續推廣0~3歲幼童全面接種流感疫苗,尤其是對0~3歲健康的幼童更應該加強宣導接種流感疫苗,以節省整個社會的醫療資源。
The government started to provide free routine influenza vaccination for the high-risk elderly above 65 years old in 1998 and further extended the coverage to infants from six months to 2 years old in 2004. Since the immunity of the infants was weaker than that of the adults, the incidence and mortality from influenza of the infants was higher than those of the elderly above 65 years old by three to five times. Moreover, the complications caused by influenza were much severer for the infants than for the adults. Therefore, influenza vaccination for infants was an important issue that was worth studying. The data were taken from the National Health Interview Survey and the database of National Health Insurance in 2001.
There were 3750 samples for children under twelve years old. In this study the samples were separated into two cohorts which were 0 to 3 years old and 4 to 12 years old respectively. Two groups, vaccinated and non-vaccinated, were included in each cohorts. Outpatient visits probability, Outpatient visit numbers, Outpatient visit cost, probability of hospitalization, numbers of hospitalization and hospitalization cost were used as medical utilization indicators. The relation between vaccination and these six indications were investigated in the study.
The results revealed that most medical utilization indicators were either non-significant or positively significant correlated to vaccination. Only outpatient cost was negatively significant linked to vaccination. Nevertheless, vaccination was also found to reduce medical resource utilization such as the number of outpatient in the descriptive analysis. Generally speaking, vaccination for children from 0 to 3 years old could reduce medical resource utilization and was effective to the whole society. Therefore, policy of routine vaccination for infants in 2004 was considered to be necessary. The government should continue to popularize the routine influenza vaccination for children under 3 years old, especially the healthy ones to save the medical resource as a whole.
第一章 緒論
1.1 研究背景
1.2 研究動機及目的
1.3 研究流程及架構
第二章 文獻參考
2.1 國內文獻
2.2 國外文獻
第三章 研究方法及樣本敘述、特性分析
3.1研究方法
3.2資料來源
3.3 資料處理
3.4 樣本分析
3.5 樣本利用醫療資源分析
第四章 實證模型及結果
4.1 實證模型之設定
4.2 變數定義
4.3 實證結果
4.3.1疫苗接種率
4.3.2 疫苗接種的效果
第五章 結論與建議
5.1結論
5.2研究限制
5.3未來研究方向
文獻參考
中文參考文獻
外文參考文獻
參考網址
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Nichol, K. L. and M. Goodman(1999)”The Health and Economic Benefits of Influenza Vaccination for Healthy and At-Risk Persons Aged 65 to 74 Years,” PharmacoEconomics, Vol. 16, pp. 63-71.
Nichol, K. L. and M. Goodman(2002)” Cost Effectiveness of Influenza Vaccination for Healthy Persons between 65 and 74 Years,” Vaccine, Vol. 20, pp. S21-S24.
Postma, M. J., J. M. Bos, M. van Gennep, J. C. Jager,R. Baltussen and M. J.W. Sprenger.(1999)”Economic Evaluation of Influenza Vaccination: Assessment for the Netherlands,” PharmacoEconomics, Vol. 16, pp. 33-40.
Tsai, Y. W., W. F. Huang, Y. W. Wen and P. F. Chen(2006)” The influence of the influenza vaccination on hospitalization costs for elderly in Taiwan,” iHEA 2005 5th World Congress. Barcelona, Spain.
Turner, D. A., A. J. Wailoo, N. J. Cooper, A. J. Sutton and K.G. Nicholson(2006)” The Cost-effectiveness of Influenza of Healthy Adults 50-64 Years of Aage,” Vaccine, Vol. 24, pp. 1035-1043.
Wood, S. C., V. H. Nguyen and C. Schmidt(2000)”Economic Evaluations of Influenza Vaccination in Healthy Working-Age Adults: Employer and Society Perspective,” PharmacoEconomics, Vol. 18(2), pp. 173-83.
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