The impact of vaccination and patient characteristics on influenza vaccination uptake of elderly people: A discrete choice experiment
The impact of vaccination and patient characteristics on influenza vaccination uptake of elderly people: A discrete choice experiment
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DOI：
10.1016/j.vaccine.2018.01.054
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发表时间：
2018-03-07
期刊：
影响因子：
5.5
通讯作者：
Bindels, Patrick
中科院分区：
文献类型：
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作者：
de Bekker-Grob, Esther W.;Veldwijk, Jorien;Bindels, Patrick
目的：为了改善患者的信息，并促进疫苗接种覆盖率符合欧盟和世界卫生组织的目标，我们旨在量化疫苗接种和患者特征对老年人流感疫苗接种的影响。方法：对1261名年龄在60岁以上的荷兰普通人群进行在线离散选择实验（DCE）。在DCE中，我们使用了基于五个疫苗接种特征的流感疫苗接种情景：有效性、严重副作用风险、轻度副作用风险、保护持续时间和吸收时间。采用异方差多项logit模型，将量表和偏好异质性（基于19个患者特征）考虑在内。结果：疫苗接种和患者特征都有助于解释流感疫苗接种。假设一个基本案例被调查者和一个现实的疫苗接种场景，预测的接种率为58%。疫苗接种特征和患者特征的单向变化使这一吸收率分别从46%上升到61%和从37%上升到95%。对疫苗接种率影响最大的是患者去年是否接种过疫苗，是否经历过疫苗接种的副作用，以及患者对疫苗接种的总体态度。结论：尽管疫苗接种特征被证明会影响流感疫苗的接种，但某些患者特征对流感疫苗的接种有更大的影响。政策制定者和全科医生可以利用这些见解来改进针对60岁或以上人群的流感疫苗接种宣传计划和信息。例如，医生应该更多地关注过去因接种疫苗而经历过副作用的患者，政策制定者应该为去年接种过疫苗的患者和未接种过疫苗的患者量身定制标准信息文件夹。(C) 2018 Elsevier Ltd.版权所有。
Objectives: To improve information for patients and to facilitate a vaccination coverage that is in line with the EU and World Health Organization goals, we aimed to quantify how vaccination and patient characteristics impact on influenza vaccination uptake of elderly people.Methods: An online discrete choice experiment (DCE) was conducted among 1261 representatives of the Dutch general population aged 60 years or older. In the DCE, we used influenza vaccination scenarios based on five vaccination characteristics: effectiveness, risk of severe side effects, risk of mild side effects, protection duration, and absorption time. A heteroscedastic multinomial logit model was used, taking scale and preference heterogeneity (based on 19 patient characteristics) into account.Results: Vaccination and patient characteristics both contributed to explain influenza vaccination uptake. Assuming a base case respondent and a realistic vaccination scenario, the predicted uptake was 58%. One-way changes in vaccination characteristics and patient characteristics changed this uptake from 46% up to 61% and from 37% up to 95%, respectively. The strongest impact on vaccination uptake was whether the patient had been vaccinated last year, whether s/he had experienced vaccination side effects, and the patient's general attitude towards vaccination.Conclusions: Although vaccination characteristics proved to influence influenza vaccination uptake, certain patient characteristics had an even higher impact on influenza vaccination uptake. Policy makers and general practitioners can use these insights to improve their communication plans and information regarding influenza vaccination for individuals aged 60 years or older. For instance, physicians should focus more on patients who had experienced side effects due to vaccination in the past, and policy makers should tailor the standard information folder to patients who had been vaccinated last year and to patient who had not. (C) 2018 Elsevier Ltd. All rights reserved.