慢性病患者接种流感疫苗的效果与效益评价

Effect and cost-benefit of influenza vaccination for patients with chronic diseases

目的评价常州市武进区慢性病患者接种流感疫苗的效果和效益。方法采用流行病学类试验研究,招募慢性病患者441名作为接种组,接种三价流感病毒裂解疫苗;并选取与接种组年龄、性别、健康状况相匹配的慢性病患者467人作为对照组,进行基线调查和为期1年的随访调查。结果观察1年后,接种组和对照组分别有431和460人完成了基线和4次随访调查。接种组和对照组流感样疾病发病率为分别为7.42%(32/431)和14.13%(65/460),差异有统计学意义(χ^2=9.634,P=0.002),保护率为47.46%,效果指数1.90;普通感冒发病率分别为16.94%(73/431)和25.43%(117/460),差异有统计学意义(χ^2=9.077,P=0.003),保护率为33.41%,效果指数1.50;慢性病发作发病率分别为5.57%(24/431)和9.35%(43/460),差异有统计学意义(χ^2=4.043,P=0.044),保护率为40.43%,效果指数1.68。人均接种效益为675.86元,效益-成本比为10.09∶1。结论慢性病患者接种流感疫苗能有效预防流感样疾病的发生,降低相关慢性病的发作,具有较好的成本效益。

Objective To evaluate the effect and cost-benefit of influenza vaccination for patients with chronic diseases in Wujin district of Changzhou City.Methods An epidemiological quasi-experiment was employed in this study.A total of 441 patients with chronic diseases were recruited as the vaccine group and inoculated with trivalent influenza virus vaccine,while 467 patients with chronic diseases matched with the age,gender and health status of the vaccine group were selected as the control group for both baseline and follow-up investigations.Results A total of 431 subjects in the vaccine group and 460 subjects in the control group completed baseline and 1-year follow-up investigations.The incidence of influenza-like illness was 7.42%(32/431)and 14.13%(65/460)in the vaccine group and the control group,respectively,with a statistically significant difference(χ^2=9.634,P=0.002).The protective rate was 47.46%,and the effect index was 1.90.The incidence of common cold was 16.94%(73/431)and 25.43%(117/460),respectively,and the difference was statistically significant(χ^2=9.077,P=0.003),with a protective rate of 33.41%,and an effect index of 1.50.The incidence of chronic disease was 5.57%(24/431)and 9.35%(43/460),respectively.The difference was statistically significant(χ^2=4.043,P=0.044),with a protective rate of 40.43%and an effect index of 1.68.The per capita benefit of inoculation was 675.86 yuan,and the benefit-cost ratio was 10.09∶1.Conclusion Influenza vaccination for patients with chronic diseases effectively prevented the occurrence of influenza-like illness and reduced the incidence of related chronic diseases.