| Summary: | 碩士 === 高雄醫學大學 === 高齡長期照護碩士學位學程 === 104 === Background and Motivation: Chronic Obstructive Pulmonary Disease (COPD) is an irreversible chronic pulmonary disease. Most of COPD cases can be noted as severe pulmonary function degeneration and long-term respiratory difficulty. When the older population is infected by influenza virus or streptococcus pneumonia, it may cause severe respiratory or systemic diseases, which increases the medical resources utilization or even the mortality. Hence, protective vaccination is recognized worldwide as convenient, economic, and the most effective method for preventing complication of influenza and streptococcus pneumonia. The purpose of this study was to explore within Taiwan area the medical utilization and expenditure, and its effectiveness of getting influenza and pneumococcal vaccinated for the elderly over 75 years old with COPD.
Methodology: In this study, the method adopted was using retrospective chart study to analyze cases on file during 2007-2011, based on National Health Insurance Research Database at National Health Research Institutes (NHRI). The vaccinating status was divided into four groups:「Influenza-Vaccinated only」,「Pneumococcal -Vaccinated only」,「Coincided-Vaccinated」, and「Unvaccinated」. Over-looking the factors of subjects’ genders, age, socio-economic status, and prior year health condition, we evaluated the medical utilization and expenditure, as well as the vaccine effectiveness during the period of 2012/1/1 to 2012/9/30.
Results: In the Influenza-vaccinated there was a raise on outpatient medical expenditure while 30% less emergency frequencies. In the Pneumococcal-Vaccinated there was no significant difference on medical expenditure for both outpatient and emergency care. In the Coincided-Vaccinated there were raise medical frequencies and expenditure on outpatient care, while 36% less emergency utilization, 36% less emergency frequency, and 0.42% less emergency expenditure. Regarding the hospitalization utilization, no significant difference was found among those four groups.
Conclusions: Findings from the study revealed that immunizing influenza and pneumococcal vaccines coincidentally could reduce the amount of medical utilization and expenditure, compared to the groups of influenza-vaccinated only, pneumococcal-vaccinated only, or unvaccinated. Although the lower rates were insignificant, the author suggested that the elderly aged over 75 with COPD be encouraged to receive annual vaccinations to lower the risk of respiratory disease.
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