北京市肺炎球菌疫苗免费接种政策对老年人肺炎住院的影响  

Effect of the free pneumococcal vaccination policy on the hospital admissions for pneumonia among the elderly in Beijing

作　　者：李雨橦 庞元捷[2] 吕敏[3] 黄旸木[1] LI Yu-tong;PANG Yuan-jie;LYU Min;HUANG Yang-mu(Department of Global Health,School of Public Health,Peking University,Beijing 100191,China;Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;Institute for Immunization and Prevention,Beijing Center for Disease Prevention and Control,Beijing 100013,China)

机构地区：[1]北京大学公共卫生学院全球卫生学系,北京100191 [2]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [3]北京市疾病预防控制中心免疫预防所,北京100013

出　　处：《中华疾病控制杂志》2023年第3期357-362,共6页Chinese Journal of Disease Control & Prevention

基　　金：北京市自然科学基金-海淀原始创新联合基金(19L2055)。

摘　　要：目的 分析北京市肺炎球菌疫苗免费接种政策实施前后北京市老年人群肺炎住院情况的变化,评估该项政策对老年人肺炎防治的效果。方法 利用北京市城镇职工医疗保险数据库2014―2019年收集的老年人群住院数据,以2019年1月作为政策的干预分界点,应用中断时间序列模型(interrupted time series, ITS)分析政策实施前后北京市老年人群肺炎住院人次的变化。结果 免费接种政策实施前北京市≥65岁老年人因肺炎住院人次呈上升趋势(RR=1.019,P<0.001),政策实施后上升趋势有所减缓(RR=0.971,P=0.013);敏感性分析中,≥65岁老年人因股骨骨折住院人次在政策实施前后则没有明显变化(RR=0.992,P=0.503)。结论 肺炎疫苗免费接种政策与老年人肺炎住院趋势减缓有一定关联,应进一步采取相关策略提高该疫苗的接种可及性。Objective To analyze the hospitalization trends for elderly pneumonia patients before and after implementing the free pneumococcal vaccination policy in Beijing, and to evaluate the policy’s influence on the prevention and treatment of pneumonia in the elderly. Methods Monthly hospital admission data was obtained from Urban Employee Basic Medical Insurance(UEBMI) in Beijing from 2014 to 2019. The policy intervention cut-off point was set in January 2019. The interruption time series(ITS) model was used to analyze the changes of hospital admissions among elderly pneumonia patients in Beijing before and after implementing the policy. Results Before the implementation of the policy, the number of hospital admissions for pneumonia among people over 65 years old in Beijing showed an upward trend(RR=1.019, P<0.001), and the trend slowed down after the implementation of the policy(RR=0.971, P=0.013). In the sensitivity analysis, there was no significant change in the number of hospital admissions for femoral fracture among people over 65 years old after the implementation(RR=0.992, P=0.503). Conclusions The free pneumococcal vaccination policy in Beijing is associated with the reduction of the risk of hospital admission for pneumonia among the elderly. Further strategies are needed to improve the accessibility of the vaccine.

关 键 词：肺炎球菌疫苗 免费接种 老年人 住院 中断时间序列 

分 类 号：R183[医药卫生—流行病学]