The Effectiveness of Annually Repeated Influenza Vaccination on Elderly with Chronic Obstructive Pulmonary Disease

• Main Authors: Fung-Ying Chang, 張芳熒
• Other Authors: Shiao-Chi Wu
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/61699473764290758126

碩士 === 國立陽明大學 === 衛生福利研究所 === 102 === Background：Influenza vaccination is the best way to protect against influenza and serious complications. But, the protection after getting vaccinated only maintains about a year. Therefore, the current recommendention is to get a vaccination annually. However, recent studies show the effectiveness of annual vaccination for decreasing the healthcare utilization, expenses and mortality risk. In addition, the elderly with chronic obstructive pulmonary disease (COPD) are high-risk group for getting influenza and infection by influenza, and these reasons would lead to higher risk in outpatient, emergency, inpatient utilization and death. So, it is important to realize about the effectiveness of getting annually repeated influenza vaccination on elderly with COPD. Objective：This study aimed to examine the effectiveness of getting annually repeated influenza vaccination on all-cause diseases hospitalization, pneumonia or influenza hospitalization utilization and expenses and all-cause death in elderly with COPD in short-term and long-term follow-up. Method：Using the National Health Insurance Databases 2009 to 2011 to conduct a retrospective cohort study. The study population was the elderly (≧66 years) with COPD lived in non-institutionalized, and divided into four groups on the basis of getting the influenza vaccination status: revaccination, current-year vaccination, pre-year vaccination and no vaccination. The study period included both short-term (three months) and long-term (nine months) follow-up periods. Using binary logistic regression and multiple regression for analysis. Result：The influenza vaccination rate was 27.36% in COPD elderly in 2010. Compared with the revaccination group, the pre-year vaccination group had less risk of all-cause diseases utilization (OR=0.79). Among the use of hospitalization, no vaccination group had longer lengths of hospitalization days in short-term follow-up period (β=0.18); pre-year vaccination and no vaccination group had and longer lengths of hospitalization days in long-term follow-up period (β=0.27, β=0.15). Among the healthcare expenditure, no vaccination group had higher healthcare expenses in short-term follow-up period(β=0.18); current-year vaccination, pre-year vaccination and no vaccination had higher healthcare expenses in long-term follow-up period (β=0.16, β=0.26, β=0.16). Among the use of pneumonia or influenza hospitalization, no vaccination group had higher healthcare expenses in short-term follow-up period (β=0.30) and pre-year vaccination had higher healthcare expenses in long-term follow-up period (β=0.29). In the all-cause death, no vaccination group had higher risk for death in both follow-up periods (short-term period：OR=2.64, long-term period：OR=2.15). Conclusion：Because the high accessibility to medical services in Taiwan, revaccination group may more likely to use medical services and led to higher all-cause hospitalization, but revaccination can decrease the lengths of hospitalization days and healthcare expenditure. Revaccination can prevent serious complications from influenza, reduce disease severity and all-cause mortality risk, but vaccination rate in elderly with COPD is low. We suggest that the government and provider should take a responsibility for promoting and educating the concept of annually vaccination in elderly with COPD.