Burden of vaccine-preventable disease in adult Medicaid and commercially insured populations Analysis of claims-based databases, 2006-2010
Burden of vaccine-preventable disease in adult Medicaid and commercially insured populations Analysis of claims-based databases, 2006-2010
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DOI：
10.4161/hv.29303
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发表时间：
2014-01-01
影响因子：
4.8
通讯作者：
Levin, Myron
中科院分区：
文献类型：
--
作者：
Krishnarajah, Girishanthy;Carroll, Charlotte;Levin, Myron
美国成年人的疫苗接种率不理想，导致潜在疫苗可预防疾病（VPD）的发病率，死亡率和经济负担。使用2006-2010年的索赔估计了19-64岁医疗补助和商业保险成年人的VPD未校正年发病率比例，沿着2010年的年龄/性别校正发病率比例。在2010年，160万医疗补助成年人（平均年龄34 +/- 12岁; 73.4%的女性）和3300万商业保险（平均年龄42（+/-）13岁; 52.2%的女性）被包括在内。经年龄/性别调整的发生率比例2010年，医疗补助与商业保险的脑膜炎球菌病成年人之间的比例（每10万人）为26.2（95% CI 22.9-29.8）vs 2.0（1.9-2.2）B型肝炎88.9（82.6-95.6）vs 17.5（17.0-17.9）肺炎球菌病98.2（91.7-105.1）vs 21.1（20.7-21.6）甲型肝炎19.8（16.9-23.1）vs 4.5（4.3-4.7）（P < 0.001）腮腺炎2.1（1.3-3.3）vs 1.4（1.3-1.6）（P = 0.14）;麻疹0.3（0.1-1.0）vs 0.3（0.2-0.3）（P = 0.38）;带状疱疹（仅60至64岁）459（408-515）vs 473（466-481）（P = 0.35）;水痘（仅限19至39岁）6.5（4.8-8.5）vs 8.0（7.5-8.5）（P = 0.12）;流感586（573-598）vs 633（631-636）（P < 0.001）;百日咳1.8（1.1-2.8）vs 3.2（3.0-3.4）（P < 0.001）。需要进行研究，以充分了解美国医疗补助成人人群中某些VPD编码发生率与商业保险成人之间差异的原因。
Vaccination rates among United States (US) adults are suboptimal, resulting in morbidity, mortality, and financial burden attributable to potentially vaccine-preventable diseases (VPDs). Unadjusted annual incidence proportions of VPDs were estimated for Medicaid and commercially insured adults aged 19-64 years using 2006-2010 claims, along with age/gender-adjusted incidence proportions for 2010. In 2010, 1.6 million Medicaid adults (mean age 34 +/- 12 years; 73.4% female) and 33 million commercially insured (mean age 42 (+/-) 13 years; 52.2% female) were included. Age/gender-adjusted incidence proportions (per 100 000) in 2010 among Medicaid vs commercially insured adults for meningococcal disease were 26.2 (95% CI 22.9-29.8) vs 2.0 (1.9-2.2) (P < 0.001); hepatitis B 88.9 (82.6-95.6) vs 17.5 (17.0-17.9) (P < 0.001); pneumococcal disease 98.2 (91.7-105.1) vs 21.1 (20.7-21.6) (P < 0.001); hepatitis A 19.8 (16.9-23.1) vs 4.5 (4.3-4.7) (P < 0.001); mumps 2.1 (1.3-3.3) vs 1.4 (1.3-1.6) (P = 0.14); measles 0.3 (0.1-1.0) vs 0.3 (0.2-0.3) (P = 0.38); herpes zoster (60-to 64-year-olds only) 459 (408-515) vs 473 (466-481) (P = 0.35); varicella (19-to 39-year-olds only) 6.5 (4.8-8.5) vs 8.0 (7.5-8.5) (P = 0.12); influenza 586 (573-598) vs 633 (631-636) (P < 0.001); and pertussis 1.8 (1.1-2.8) vs 3.2 (3.0-3.4) (P < 0.001). Research is needed to fully understand the causes of the disparity of the coded incidence of some VPDs in adult Medicaid population than commercially insured adults in the US.