北京市老年人免费流感疫苗接种率及认知影响因素调查分析

摘要

目的：评价2007年老年人免费接种流感疫苗政策推出以后，北京市老年人流感疫苗接种率及认知影响因素。方法2011年7月采用多阶段整群随机抽样法在北京市6个城区和7个郊区共抽取20个社区（其中城区12个，郊区8个），每个社区50名60岁及以上老年人，其中户籍为北京市的老年人为924名。采用自制问卷对老年人进行调查，人口学特征采用描述性分析，疫苗接种率、政策知晓率、流感知识和疫苗知识得分比较采用χ2检验，疫苗接种率的影响因素采用多因素非条件 Logistic 回归分析。结果2007年前1年，914名老年人中接种疫苗的有291名，接种率为31,84%；2007年后1年，903名老年人中接种疫苗的有578名，接种率为64,01%，2007年前后疫苗接种率比较，差异有统计学意义（χ2=188,40，P <0,01）。知道“北京市60岁及以上老人可以免费接种流感疫苗”政策的共有869名（94,05%）。578名接种过免费流感疫苗的老年人中觉得“政府在为老百姓健康着想”的有559人（96,71%）。不同年龄段老年人政策知晓率比较，差异有统计学意义（P <0,01）。老年人流感知识平均得分为（9,8±2,0）分，不同年龄段和户籍老年人流感知识得分比较，差异有统计学意义（ P <0,05）。老年人疫苗知识平均得分为（2,2±1,1）分，不同户籍老年人疫苗知识得分比较，差异有统计学意义（ P <0,05）。以2007年后是否接种过免费流感疫苗为因变量，在控制性别、年龄、户籍因素后，政策知晓率和疫苗知识进入回归模型（P <0,05），知道该政策的人群疫苗接种率是不知道的2,860倍，疫苗知识得分3分和4分的人群疫苗接种率分别是得分0分人群的3,517倍和3,511倍。结论免费流感疫苗政策推出以后，疫苗接种率明显提高。老年人对该政策和政府有较高的满意度。老年人流感知识得分较高，流感疫苗知识得分偏低。政策知晓率和流感疫苗认知情况影响疫苗接种率。%Objective To investigate the free influenza vaccination coverage and its influencing factors about cognition among elderly population in Beijing after the free influenza vaccination policy among elderly population was implemented in 2007, Methods In July 2011,by multi - stage cluster sampling method,20 communities(12 from urban area,8 from sub-urbs)were selected from 6 urban areas and 7 suburbs in Beijing city,then 50 elderly people aged 60 and above were selected from each of the 20 communities,924 elderly people had registered permanent residence of Beijing, A self - designed question-naire was used to survey these elderly people, Descriptive analysis was used for demographic characteristics, Chi - square test was used for the difference between the vaccination coverage,awareness rate of policy,scores of influenza knowledge and influenza vaccine knowledge before and after 2007, Multivariate nonconditional Logistic regression model was used to analyze the influencing factors for free influenza vaccine coverage, Results Before 2007,among 914 subjects,291 received vaccine,vaccination cov-erage was 31, 84% ;After 2007,among 903 subjects,578 received vaccine,vaccination coverage was 64, 01% ,there was sig-nificant difference between vaccination coverage before 2007 and vaccination coverage after 2007(χ2 = 188, 40,P < 0, 01), A total of 869(94, 05% )subjects knew the policy " Elderly people aged 60 and above in Beijing can get free influenza vaccine", Among 578 elderly people who had received free influenza vaccination,559(96, 71% )had the idea " The government is ser-ving peopleˊs health" , There was significant difference in awareness rate of policy among elderly people with different age(P <0, 01), The average score for influenza knowledge among elderly people was(9, 8 ± 2, 0),there was significant difference in score for influenza knowledge among elderly people with different age and registered permanent residence(P < 0, 05), The aver-age score for vaccine knowledge among elderly people was(2, 2 ± 1, 1),there was significant difference in score for vaccine knowledge among elderly people with different registered permanent residence(P < 0, 05), " If one had received free influenza vaccination or not" was regarded as dependent variable,when the factors such as gender,age,registered permanent residence were controlled,awareness rate of policy and vaccine knowledge entered regression model( P < 0, 05),influenza vaccination coverage among group who knew the policy was 2, 860 times than that among group who didnˊt know the policy,influenza vaccina-tion coverage among group who got 3 on vaccine knowledge score was 3, 517 times than that among group who got 0 on vaccine knowledge score,influenza vaccination coverage among group who got 4 on vaccine knowledge score was 3, 511 times than that a-mong group who got 0 on vaccine knowledge score, Conclusion After the free influenza vaccination policy among elderly popula-tion was implemented in 2007,influenza vaccination coverage increased obviously, The old people were highly satisfied with the policy and the government, The awareness rate of influenza knowledge among the elderly people was high,but awareness rate of influenza vaccine knowledge was relatively low, The awareness rate of policy and cognition level of influenza vaccine influence the vaccination coverage obviously.