北京市肺炎球菌疫苗免费接种政策对老年人肺炎住院的影响

李雨橦; 庞元捷; 吕敏; 黄旸木

doi:10.16462/j.cnki.zhjbkz.2023.03.020

北京市肺炎球菌疫苗免费接种政策对老年人肺炎住院的影响

doi: 10.16462/j.cnki.zhjbkz.2023.03.020

1.
100191 北京，北京大学公共卫生学院全球卫生学系
2.
100191 北京，北京大学公共卫生学院流行病与卫生统计学系
3.
100013 北京，北京市疾病预防控制中心免疫预防所

基金项目:

北京市自然科学基金-海淀原始创新联合基金 19L2055

详细信息

通讯作者:
黄旸木，E-mail: ymhuang@bjmu.edu.cn

中图分类号: R183
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- 被引次数: 0
出版历程
- 收稿日期: 2021-12-14
- 修回日期: 2022-08-13
- 网络出版日期: 2023-04-04
- 刊出日期: 2023-03-10

Effect of the free pneumococcal vaccination policy on the hospital admissions for pneumonia among the elderly in Beijing

1.
Department of Global Health, School of Public Health, Peking University, Beijing 100191, China
2.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
3.
Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing 100013, China

Funds:

Beijing Natural Science Foundation-Haidian Original Innovation Joint Fund 19L2055

More Information

Corresponding author: HUANG Yang-mu, E-mail: ymhuang@bjmu.edu.cn

摘要

摘要: 目的分析北京市肺炎球菌疫苗免费接种政策实施前后北京市老年人群肺炎住院情况的变化，评估该项政策对老年人肺炎防治的效果。方法利用北京市城镇职工医疗保险数据库2014―2019年收集的老年人群住院数据，以2019年1月作为政策的干预分界点，应用中断时间序列模型(interrupted time series, ITS)分析政策实施前后北京市老年人群肺炎住院人次的变化。结果免费接种政策实施前北京市≥65岁老年人因肺炎住院人次呈上升趋势(RR=1.019，P < 0.001)，政策实施后上升趋势有所减缓(RR=0.971，P=0.013)；敏感性分析中，≥65岁老年人因股骨骨折住院人次在政策实施前后则没有明显变化(RR=0.992，P=0.503)。结论肺炎疫苗免费接种政策与老年人肺炎住院趋势减缓有一定关联，应进一步采取相关策略提高该疫苗的接种可及性。
- 肺炎球菌疫苗 /
- 免费接种 /
- 老年人 /
- 住院 /
- 中断时间序列
Abstract: Objective To analyze the hospitalization trends for elderly pneumonia patients before and after implementing the free pneumococcal vaccination policy in Beijing, and to evaluate the policy's influence on the prevention and treatment of pneumonia in the elderly. Methods Monthly hospital admission data was obtained from Urban Employee Basic Medical Insurance (UEBMI) in Beijing from 2014 to 2019. The policy intervention cut-off point was set in January 2019. The interruption time series (ITS) model was used to analyze the changes of hospital admissions among elderly pneumonia patients in Beijing before and after implementing the policy. Results Before the implementation of the policy, the number of hospital admissions for pneumonia among people over 65 years old in Beijing showed an upward trend (RR=1.019, P < 0.001), and the trend slowed down after the implementation of the policy (RR=0.971, P=0.013). In the sensitivity analysis, there was no significant change in the number of hospital admissions for femoral fracture among people over 65 years old after the implementation (RR=0.992, P=0.503). Conclusions The free pneumococcal vaccination policy in Beijing is associated with the reduction of the risk of hospital admission for pneumonia among the elderly. Further strategies are needed to improve the accessibility of the vaccine.
- Pneumococcal vaccine /
- Free vaccination /
- Elderly people /
- Hospital admission /
- Interruption time series

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图 1 2014―2019年北京市≥65岁老年人每月因肺炎住院人次变化趋势

Figure 1. The trend of monthly hospital admissions for pneumonia among people over 65 years old in Beijing from 2014 to 2019

下载: 全尺寸图片幻灯片

图 2 2014―2019年北京市≥65岁老年人每月因肺炎住院人次变化趋势

注：黑色虚线为未经过季节性调整的变化趋势。

Figure 2. Trend of monthly hospital admissions for pneumonia among people over 65 years old in Beijing from 2014 to 2019

下载: 全尺寸图片幻灯片

图 3 2014―2019年≥65岁老年人每月因股骨骨折住院人次

注：黑色虚线为未经过季节性调整的变化趋势。

Figure 3. Monthly hospital admissions for femoral fracture among people over 65 years old from 2014 to 2019

下载: 全尺寸图片幻灯片

表 1 2019年北京市≥65岁老年人肺炎球菌疫苗接种率

Table 1. Pneumococcal vaccination rate of people over 65 years old in Beijing in 2019

分组	接种人数 (例)	北京市老龄人口数(万)	接种率(%)
性别
男	160 084	118.8	13.48
女	179 497	134.0	13.40
年龄组(岁)
65~ < 80	275 819	189.7	14.54
≥80	63 762	63.1	10.10

下载: 导出CSV

表 2 2014―2019年北京市≥65岁老年人因肺炎住院人次描述统计[n(%)]

Table 2. Summary statistics of hospital admissions for pneumonia among people over 65 years old from 2014 to 2019 [n(%)]

年份 (年)	性别		年龄组(岁)		总计
年份 (年)	男	女	65~ < 80	≥80	总计
2014	4 519(51.9)	4 194(48.1)	4 399(50.5)	4 314(49.5)	8 713
2015	5 626(53.9)	4 804(46.1)	4 853(46.5)	5 577(53.5)	10 430
2016	7 286(52.8)	6 522(47.2)	6 036(43.7)	7 772(56.3)	13 808
2017	9 058(53.2)	7 951(46.7)	7 306(42.9)	9 708(57.1)	17 014
2018	13 091(52.6)	11 787(47.4)	11 047(44.4)	13 831(55.6)	24 878
2019	14 354(52.2)	13 148(47.8)	12 015(43.7)	15 487(56.3)	27 502
合计	53 934(52.7)	48 411(47.3)	45 656(44.6)	56 689(55.4)	102 345

下载: 导出CSV

表 3 ITS分析2014―2019年北京市≥65岁老年人每月因肺炎住院人次

Table 3. ITS analysis: monthly hospital admissions for pneumonia among people over 65 years old in Beijing from 2014 to 2019

参数	RR值	(95% CI)值	t值	P值
≥65岁
时间项	1.019	1.017~1.022	15.613	< 0.001
干预项	6.693	1.450~30.893	2.436	0.015
趋势项	0.971	0.949~0.994	-2.474	0.013
≥80岁
时间项	1.019	1.016~1.021	14.733	< 0.001
干预项	7.920	1.681~37.321	2.617	0.009
趋势项	0.968	0.946~0.992	-2.670	0.008

下载: 导出CSV

表 4 ITS分析2014―2019年≥65岁人群每月因股骨骨折住院人次

Table 4. ITS analysis: monthly hospital admissions for femoral fracture among people over 65 years old from 2014 to 2019

参数	RR值	(95% CI)值	t值	P值
时间项	1.013	1.011~1.015	12.497	< 0.001
干预项	1.617	0.369~7.096	0.637	0.524
趋势项	0.992	0.970~1.015	-0.669	0.503

下载: 导出CSV

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