Determinants of willingness to pay for self-paid vaccines in China
Determinants of willingness to pay for self-paid vaccines in China
复制标题
DOI：
10.1016/j.vaccine.2014.06.047
复制
发表时间：
2014-07-31
期刊：
影响因子：
5.5
通讯作者：
Zhang, Yuting
中科院分区：
文献类型：
--
作者：
Hou, Zhiyuan;Chang, Jie;Zhang, Yuting
背景：虽然中国扩大免疫规划未涵盖的疫苗可以自愿自费接种，但自费疫苗在中国的使用率很低。目的：了解自费疫苗的支付意愿及其影响因素。方法：2013年，随机抽取3省108个社区的2160户0-3岁儿童家庭进行访谈。采用竞价博弈法对自费疫苗7价肺炎球菌结合疫苗和流感疫苗进行WTP诱导。我们进行了多元线性回归来确定影响WTP的因素。结果：肺炎球菌结合疫苗和流感疫苗的中位WTP分别为200元和60元（10美元）。92%和55%的受访者分别表示不愿意支付这两种疫苗的市场价格。较低的价格壁垒和较高的支付能力与较高的WTP相关。那些拥有更好的疫苗或疾病相关知识、感知到的脆弱性和疾病严重程度更高的人愿意支付更多的钱。然而，疫苗接种的有效性和安全性障碍对WTP没有显著影响。来自同行和医疗保健提供者的建议提高了WTP。孩子的父亲和祖父母的WTP高于他们的母亲。WTP随年龄的增长而下降，但不受教育程度和职业的影响。结论：在我们的研究中，大多数个体不愿意以市场价格购买自费疫苗，以预防高负担疾病。因此，应消除疫苗接种的经济障碍，以增加需求。关于疾病负担、财政能力和成本效益的具体区域信息对于制定地方筹资政策以支付疫苗接种费用非常重要。针对心理社会因素的干预措施，如卫生教育和与提供者和同伴的沟通，也可以有效地提高这些疫苗的接种率。(C) 2014 Elsevier Ltd.版权所有。
Background: While vaccines not covered by China's Expanded Program on Immunization can be received voluntarily with out-of-pocket payment, the uptake of self-paid vaccines in China is low.Objective: To investigate willingness to pay (WTP) for self-paid vaccines and its determinants in China.Methods: We interviewed 2160 randomly selected households with children 0-3 years old, in 108 communities from three provinces in 2013. A bidding game method was used to elicit WTP for two self-paid vaccines: 7-valent pneumococcal conjugate vaccine and influenza vaccine. We conducted multivariate linear regressions to determine factors affecting the WTP.Results: Median WTP for pneumococcal conjugate vaccine and influenza vaccine were Chinese Yuan 200 and 60 (10 US Dollars). 92% and 55% of respondents, respectively were not willing to pay the market price for these two vaccines. Lower price barrier and higher ability to pay were associated with higher WTP. Those with better vaccine or disease-related knowledge, higher perceived vulnerability and severity of diseases were willing to pay more. However, perceived effectiveness and safety barriers to vaccination had no significant effects on the WTP. Recommendations from peers and healthcare providers increased the WTP. Fathers and grand parents of children had a higher WTP than their mothers. The WTP decreased with age, but was not affected by education and occupation.Conclusions: The majority of individuals, in our study, were not willing to pay the market price for self-paid vaccines against high-burden diseases in China. The economic barriers to vaccination should therefore be removed to increase the demand. Region-specific information about disease burden, fiscal capacity and cost-effectiveness is important for the development of local financing policy in order to cover vaccination costs. Interventions targeting psychosocial factors, such as health education and communication with providers and peers, could also be effective in increasing the uptake of these vaccinations. (C) 2014 Elsevier Ltd. All rights reserved.