北京市老年人家庭结构对其免费接种流感疫苗的影响

Analysis of vaccination coverage of the elderly influenced by different family structures in Beijing

目的分析北京市免费流感疫苗政策下家庭结构对60岁以上老年人流感疫苗接种率的影响。方法采用横断面调查，通过多阶段分层随机抽样，于2013年7—8月在北京市抽取1717名老年人进行问卷调查，回收有效问卷1637份。调查其社会人口学特征和流感疫苗接种情况。采用x。检验比较不同特征老年人疫苗接种率差异。采用多因素二分类非条件logistic回归模型分析影响老年人疫苗接种的因素。结果2013年北京市老年人免费流感疫苗接种率为38．8％（634／1637）。不同家庭结构老年人疫苗接种率差异具有统计学意义（χ2=11．57，P=0．009），其中独居老年人的接种率较高，为47．5％（58／122），和子女及配偶同住的老年人接种率较低，为34．6％（175／506），仅和配偶居住、仅和子女居住以及其他家庭结构老年人的接种率分别为41．5％（322／778）、34．7％（69／201）和33．3％（10／30）。调整了性别、收入和文化程度后，与独居老年人相比，仅和配偶居住、仅和子女居住、和配偶及子女居住老年人接种疫苗的OR（95％CI）值分别为0．90（0．60～1．33）、0．59（0．37～0．96）、0．63（0．42～0．96）。结论北京市老年人免费流感疫苗接种率较低；独居老年人的免费流感疫苗接种率高于非独居老年人。

Objective To investigate the differences in fi＇ee influenza vaccination rate among different family structures of the elderly population in Beijing under the free vaccination policy. Methods A cross sectional study was conducted by a multi-stage cluster sampling from July to August in 2013. A total of 1 717 individuals were selected to answer a self-designed questionnaire of demographic characteristics and basic information about receiving free influenza vaccination and 1 637 of which were valid. The chi-square test for dichotomous variables was calculated to examine the relationship between vaccine status and family characteristics. Predictor variables were selected as variables for non-conditional logistic regression model to determine potential independent predictors of vaccine uptake. Results The free influenza vaccination rate in elderly population was 38.8% （634/1 637） in 2013. The rate in the old people who lived alone was the highest which was 47.5% （58/122）, The rate in the old people who lived with children and spouse was 34.6% （175/506）. There was a significant difference in coverage rate among different family structures （χ2=l 1.57, P=0.009）. The rate in the old people who lived with spouse only, lived with children only and other types were 41.5% （322/778） , 34.7% （69/201）, and 33.3% （10/30）, respectively. In a muhi-factor model, there was a significant difference in vaccination rate among different family structures after other confounding factors were controlled. The odds ratios （95% C/） of the people living with spouse only, people living with children only and people living with spouse and children were 0.90 （0.60- 1.33） , 0.59 （0.37-0.96） , and 0.63 （0.42-0.96）, respectively. Conclusion The vaccination rate in the old people living alone was low. The health education should be conducted not only in the elderly people but also in their family members.