2020—2022年江苏省无锡市预防接种异常反应保险补偿分析  

Insurance-based compensation for adverse reactions following immunization in Wuxi City,Jiangsu Province from 2020 to 2022

作　　者：杨旭 王玲玲 王旭雯[1] YANG Xu;WANG Lingling;WANG Xuwen(Department of Immunization Program,the Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University,Wuxi Center for Disease Control and Prevention,Wuxi,Jiangsu 214023,China)

机构地区：[1]无锡市疾病预防控制中心(南京医科大学附属无锡疾病预防控制中心)免疫规划科,江苏无锡214023

出　　处：《上海预防医学》2024年第8期814-822,共9页Shanghai Journal of Preventive Medicine

基　　金：无锡市医学发展学科项目(FZXK2021010)。

摘　　要：【目的】分析江苏省无锡市预防接种异常反应保险补偿实施情况。【方法】收集2020—2022年无锡市预防接种异常反应基础保险和商业补充保险补偿个案信息,进行描述性流行病学分析。【结果】实施预防接种异常反应保险补偿期间共补偿病例2272例,补偿金额525.59万元,平均每例补偿0.23万元,基础保险补偿例数和金额分别占0.62%、10.72%,补充保险补偿例数和金额分别占99.43%、89.28%。基础保险中残疾、三级损害补偿分别占63.18%、88.71%,补充保险中四级及以下损害补偿占96.52%。补充保险补偿率高于基础保险。保险补偿0~岁组最多,国家免疫规划(EPI)疫苗补偿例数、金额最多分别占70.11%、73.84%。基础保险中卡介苗(BCG)补偿例数最多;补充保险中EPI疫苗补偿例数前3位为麻腮风联合减毒活疫苗、乙型肝炎疫苗、无细胞百白破联合疫苗,非EPI疫苗前3位为13价肺炎球菌多糖结合疫苗、吸附无细胞百白破灭活脊髓灰质炎和b型流感嗜血杆菌联合疫苗、肠道病毒71型灭活疫苗。基础保险中血小板减少性紫癜(症)、BCG局部脓肿补偿例数均占21.43%,补充保险中呼吸系统疾病补偿例数占77.47%。受种者报案至提交补偿材料(<31 d)、提交补偿材料至补偿款支付(≤14 d)的时间间隔,基础保险分别占71.43%、57.14%,补充保险分别占90.22%、86.23%。【结论】无锡市预防接种异常反应商业补充保险较大程度地弥补了基础保险在补偿范围和效率等方面的不足,建议进一步推广低龄儿童商业补偿保险、加强商业补充保险补偿监管。[Objective]To assess the implementation of insurance-based compensation for adverse reactions following immunization in Wuxi City,Jiangsu Province.[Methods]Data on basic insurance and supplementary insurance for adverse reactions following immunization from 2020 to 2022 in Wuxi City was collected,and a descriptive epidemiological method was used to analyze the data.[Results]A total of 2272 cases were compensated for adverse reactions following immunization,with a total compensation amount of 5.2559 million yuan,and an average of 2.3 thousand yuan per case.Basic insurance accounted for 0.62%of the total cases and 10.72%of the total compensation amount,while supplementary insurance accounted for 99.43%of the total cases and 89.28%of the total compensation amount.Compensation amounts for disability and third-degree damage in basic insurance accounted for 63.18%and 88.71%,respectively,while fourth-degree and lower damage in supplementary insurance accounted for 96.52%.The compensation rate for supplementary insurance was higher than that for basic insurance.The highest number of compensated cases was in the 0‒year age group,and vaccines included in the Expanded Program on Immunization(EPI)accounted for the majority of the cases and compensation amounts,with a percentage of 70.11%and 73.84%,respectively.For basic insurance,the largest number of compensated cases involved the Bacillus Calmette-Guérin(BCG)vaccine.For supplementary insurance,the top three compensated cases for EPI vaccines were the measles-mumps-rubella(MMR)vaccine,the hepatitis B(HepB)vaccine,and the acellular diphtheria-tetanus-pertussis(DTaP)vaccine.For non-EPI vaccines,the top three compensated cases were the 13 valent pneumococcal polysaccharide conjugate(PPCV13)vaccine,the acellular DPT-inactivated poliovirus-haemophilus influenzae type b combined vaccine(DPT-IPV/Hib),and enterovirus 71(EV71)inactivated vaccine.In basic insurance,thrombocytopenic purpura and BCG local abscess both accounted for 21.43%of the cases,while in supplementary insurance

关 键 词：疫苗 预防接种异常反应 基础保险 补充保险 补偿 

分 类 号：R186[医药卫生—流行病学]