Hoshi Shu-Ling, Kondo Masahide, Okubo Ichiro
Doctoral Program in Human-Care Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan.
Nihon Koshu Eisei Zasshi. 2008 Jan;55(1):19-29.
In 2001, Japan launched a nationwide subsidy program for influenza immunization of the elderly, whose implementation was devolved to municipalities. Rapid appraisal of the financial impact and utilisation are helpful for evaluating public programs. The government appraised uptake rate with a resource-consuming complete survey. In the present study, the authors carried out a simple and easy sample survey, with a simple random sampling method, to estimate averages of co-payment, subsidy, and total price for one vaccination. The utility of a simple random sampling method for a nationwide survey is also discussed.
A total of 300 individuals were randomly selected from about 22 million senior citizens in the 2001/2 season. A questionnaire is sent to their municipal authorities, inquiring about the price of vaccination, the target population size, and the numbers of vaccinated seniors from 2001/2 to 2004/5. Annual changes and the differences between urban and rural areas were examined with analysis of variance and regression analysis.
The response rate is 94.0%. Nationwide average prices of vaccination in terms of co-payment, subsidy, and total price changes from 2001/2 to 2004/5 were as follows: the co-payments were yen 1134, yen 1136, yen 1139, yen 1129 and yen 1148; the subsidies were yen 2972, yen 2955, yen 2966, yen 2954 and yen 2941; and the total prices are yen 4194, yen 4169, yen 4178, yen 4156 and yen 4142. No statistically significant differences were found in the annual rates. Vaccine uptake rates from 2001/2 to 2003/4 were 29.9%, 37.8%, 46.1%, 49.6%, showing a statistically significant increase.
These are the first estimates of price and uptake rates of influenza vaccination for the elderly in Japan by a sample survey method. The results demonstrate that the co-payment, subsidies, and the total price have not changed significantly since the program started, but that uptake has improved. The results also suggest that simple random sampling methods are useful for rapid appraisal of the nationwide trends with public programs devolved to municipalities.
2001年，日本启动了一项针对老年人流感疫苗接种的全国性补贴计划，该计划的实施下放到各市政当局。快速评估其财务影响和利用率有助于评估公共项目。政府通过一项耗费资源的全面调查来评估接种率。在本研究中，作者采用简单随机抽样方法进行了一项简单易行的抽样调查，以估算每次疫苗接种的自付费用、补贴和总价的平均值。还讨论了简单随机抽样方法在全国性调查中的实用性。
在2001/2季节从约2200万老年人中随机选取300人。向他们所在的市政当局发送问卷，询问疫苗接种价格、目标人群规模以及2001/2至2004/5期间接种疫苗的老年人数量。通过方差分析和回归分析研究年度变化以及城乡差异。
回复率为94.0%。2001/2至2004/5年期间，全国范围内疫苗接种的自付费用、补贴和总价的平均价格如下：自付费用分别为1134日元、1136日元、1139日元、1129日元和1148日元；补贴分别为2972日元、2955日元、2966日元、2954日元和2941日元；总价分别为4194日元、4169日元、4178日元、4156日元和4142日元。各年度费率未发现统计学上的显著差异。2001/2至2003/4年的疫苗接种率分别为29.9%、37.8%、46.1%、49.6%，呈统计学上的显著上升。
这些是通过抽样调查方法对日本老年人流感疫苗接种价格和接种率的首次估算。结果表明，自该计划启动以来，自付费用、补贴和总价没有显著变化，但接种情况有所改善。结果还表明，简单随机抽样方法对于快速评估下放到市政当局的公共项目的全国趋势很有用。
