Patrick K M, Woolley F R
JAMA. 1981 Feb 6;245(5):473-7.
To determine whether immunization against pneumococcal pneumonia could be justified on the basis of a favorable benefit to cost ratio, we evaluated the projected impact of a program of pneumococcal vaccination on the population of a health maintenance organization. Retrospective data on average provider and patient costs associated with episodes of pneumococcal pneumonia were coupled with forecasts of the likely effectiveness of currently available vaccine and its impact on anticipated incidence of pneumonia. We found that when provider-centered and patient-centered costs and benefits were added, a program of immunizing those traditionally considered to be at high risk of contracting pneumococcal pneumonia (50 years of age and older; patients with chronic diseases of the heart, liver, lungs, or kidneys; and those with diabetes mellitus) was justified on a cost-benefit basis.
为了确定基于有利的成本效益比进行肺炎球菌肺炎免疫接种是否合理，我们评估了肺炎球菌疫苗接种计划对一个健康维护组织人群的预期影响。将与肺炎球菌肺炎发作相关的平均医疗服务提供者和患者成本的回顾性数据，与现有疫苗可能的有效性及其对预期肺炎发病率影响的预测相结合。我们发现，当将以医疗服务提供者为中心和以患者为中心的成本及效益相加时，对那些传统上被认为患肺炎球菌肺炎高风险人群（50岁及以上；患有心脏、肝脏、肺部或肾脏慢性疾病的患者；以及糖尿病患者）进行免疫接种的计划在成本效益基础上是合理的。
