Evaluation of the Effect of Influenza Vaccination on Medical Utilization of the Asthmatic Patients

• Main Authors: Chi-Cheng Lin, 林基正
• Other Authors: Yong-Yuan Chang
• Format: Others
• Language: zh-TW
• Published: 2006
• Online Access: http://ndltd.ncl.edu.tw/handle/49128074169066721933

碩士 === 高雄醫學大學 === 醫務管理學研究所碩士在職專班 === 94 === This research is to analyze the data retrieved from National Health Insurance Research Database and to evaluate the vaccination rate of influenza among the asthmatic patients. Furthermore, the research is to evaluate whether influenza vaccination results in differences in medical utilization and medical expenditure among asthmatic patients and influenza-related pneumonia. This is retrospective study and based on the data of asthmatic patients from 2001 to 2002, retrieved from the first group of Registry for beneficiaries from National Health Insurance Research Database. There are 1,559 asthmatic patients in 42,617 patients in this group in 2001 and prevalence rate of asthma is 3.66％.In 2002, there are 1,534 asthmatic patients in 42,207 patients in this group and prevalence rate of asthma is 3.63%. In 2001, 179 patients received influenza vaccination among 1,559 asthmatic patients and vaccination rate is 11.48%. In 2002, 190 patients received influenza vaccination among 1,534 asthmatic patients and vaccination rate is 12.39%. 169 of 179 in 2001 and 164 of 190 in 2002 patients with asthma that received influenza vaccination are enrolled in this research. Another 169 asthmatic patients in 2001 and 164 asthmatic patients in 2002 without influenza vaccination were chosen based on sex and age are serving as matched group. The software of SPSS 10.0 for Windows was used for statistical analysis. The medical utilization ( outpatient visits, emergency visits and days of hospitalization ) and medical expenditure ( outpatient service expenditure, emergency service expenditure and hospitalization service expenditure ) available 1 year after vaccination are analyzed. Results: There are 167 men and 166 women in the vaccinated group and matched group individually. Mean age of the vaccinated group and matched group are 77.60 and 76.88 in 2001 and 77.49 and 77.27 in 2002. In analysis of medical utilization, the mean OPD visit of asthma in the vaccinated group is 48.55 times and the match group is 38.59 times. This is statistically significant between the two groups. The average hospitalization day caused by asthma in the vaccinated group is 7.24 days and the match group is 15.75 days. The average hospitalization day caused by influenza or pneumonia in the vaccinated group is 10.68 days and the match group is 22.86 days. Both are statistically significant between the two groups. In analysis of medical expenditure, the average OPD expenditure caused by asthma in the vaccinated group is 935.15 NT dollars and the match group is 1033.39 NT dollars. The average emergency expenditure caused by asthma in the vaccinated group is 2690.86 NT dollars and the match group is 3841.64 NT dollars. The average hospitalization expenditure caused by asthma in the vaccinated group is 35387.54 NT dollars and the match group is 93188.67 NT dollars. The average OPD expenditure caused by influenza or pneumonia in the vaccinated group is 477.52 NT dollars and the match group is 2603.04 NT dollars. The average emergency expenditure caused by caused by influenza or pneumonia in vaccinated group is 2517.20 NT dollars and match group is 15670.67 NT dollars. These are all statistically significant between the two groups. Conclusion: This study shows that the hospitalization day of the vaccinated group is shorter than in the unvaccinated group. The medical expense of OPD visit, emergency visit and hospitalization of the vaccinated are less expensive than the unvaccinated group in asthma, influenza or pneumonia. The unvaccinated group has 2-4 folds of OPD or ER visits and admission to hospital of higher level compared to lower level.