Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China.
School of Public Health, Peking University, Beijing, China.
Hum Vaccin Immunother. 2023 Dec 31;19(1):2167439. doi: 10.1080/21645515.2023.2167439. Epub 2023 Feb 7.
Preventive health workers rather than general practitioners (GPs) are the principal providers of vaccines in China, which may be a determinant of the unmet demand for vaccination, especially for adults, in recent years. GPs' preferences had a significant influence on alternative approaches to adult vaccination delivery. To better understand GP's preferences for adult vaccination services, we employed a discrete choice experiment with seven attributes: income, setting, information system, workshop, workload, performance measurement, and managerial support. Mixed logit models and latent class models were used for statistical analyses. In general, support from primary healthcare managers was the strongest driver of choice, followed by a 10% increase in workload, separate adult vaccination clinic, 5% increase in workload, and independent information system. Monthly income was significantly associated with provision of adult vaccination services. Based on the influence of latent factors, GPs fell into three classes that were correlated with GPs' years of practice, workload, income satisfaction, and knowledge-attitude-practicescore. Classes 1 and 2 valued the service setting and performance measurement differently, while Class 3 valued the service setting only (preferred separate adult vaccination clinics to provide service). This study generated actionable information to guide innovation in the adult vaccination delivery system in China.
在中国，预防保健工作者而非全科医生（GP）是疫苗的主要提供者，这可能是近年来疫苗接种需求未得到满足的一个决定因素，尤其是针对成年人。GP 的偏好对成人疫苗接种服务的替代方法有重大影响。为了更好地了解 GP 对成人疫苗接种服务的偏好，我们采用了具有七个属性的离散选择实验：收入、设置、信息系统、研讨会、工作量、绩效衡量和管理支持。使用混合对数模型和潜在类别模型进行统计分析。一般来说，初级卫生保健经理的支持是选择的最强驱动力，其次是工作量增加 10%、单独的成人疫苗接种诊所、工作量增加 5%和独立的信息系统。月收入与提供成人疫苗接种服务显著相关。基于潜在因素的影响，GP 分为三类，与 GP 的从业年限、工作量、收入满意度和知识-态度-实践评分相关。第 1 类和第 2 类对服务设置和绩效衡量的重视程度不同，而第 3 类只重视服务设置（倾向于提供单独的成人疫苗接种诊所）。本研究提供了可操作的信息，以指导中国成人疫苗接种服务提供系统的创新。
