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    Please use this identifier to cite or link to this item: http://asiair.asia.edu.tw/ir/handle/310904400/111314


    Title: 台灣65歲以上失智症老人接種流感疫苗之成效分析
    Authors: 鍾承芳
    Contributors: 健康產業管理學系健康管理組
    Keywords: 失智症老人、流行性感冒、流感疫苗、成效分析、Dementia Elderly、Influenza、Flu vaccine、Effectiveness
    Date: 2018
    Issue Date: 2018-08-14 15:09:01 (UTC+8)
    Publisher: 亞洲大學
    Abstract: 目的:流行性感冒為流感病毒所引起之急性傳染病,具有傳播快速、範圍廣泛及可能併發重症等特性。過去研究證實,接種流感疫苗能有效減少流感併發重症及死亡情形,因此接種流感疫苗被視為最有效的預防方法。目前仍未有研究針對健康狀況及就醫可近性相對弱勢的失智症老人進行評估,因此在人口老化、失智症人口快速增加之際,本研究特別針對失智症老人為研究對象,探討流感疫苗的接種成效。

    方法:本研究為觀察性研究,資料來源為2010-2012年全民健保資料庫之特殊需求申請檔,研究對象為65歲以上之失智症老人。統計分析部分以羅吉斯迴歸及複迴歸分析有無接種流感疫苗對流感及其併發症(肺炎及流感、急慢性呼吸系統疾病、急性腦血管疾病、心臟疾病)短期(1-3月)與長期(1-9月)之門診、住院醫療利用及全因性死亡。

    結果:本研究對象共計114,712人,流感疫苗接種率為33.3%。在控制年齡、性別、是否為低收入戶、合併症、過去一年西醫門診和過去一年住院醫療利用後,本研究結果顯示相對未接種流感疫苗組,有接種流感疫苗組並未發現減少流感及併發症之門診利用與費用,但僅納入罹患該項疾病之研究對象分析則有相對降低門診費用的發生,顯示罹病後可降低疾病嚴重程度;住院部分,有接種流感疫苗較無接種疫苗者,可顯著減少短期與長期肺炎及流感、急慢性呼吸系統疾病、急性腦血管疾病、心臟疾病之住院利用、費用與住院天數;全因性死亡部分,有接種流感疫苗較無接種者可顯著減少短期25.4%及長期23.5%之全因性死亡率。
    結論:本研究結果發現失智症老人接種流感疫苗可顯著減少流感及併發症之住院情形及死亡風險,政策上應鼓勵失智症老人接種流感疫苗以提升保護力。
    Objectives: Influenza, which is a virus-induced acute infectious disease, spreads rapidly and widely and may incur complications. Vaccination is regarded as the most effective defense against influenza because studies have shown that influenza vaccination effectively reduces the likelihood of complications and death. However, studies have not been conducted on older adults with dementia, who are disadvantageous in terms of health conditions and medical accessibility. Due to population aging and a rapid increase in the dementia population, this study examined the effectiveness of influenza vaccination on older adults with dementia.

    Methods: An observational study was conducted on adults aged 65 years or higher who were diagnosed with dementia. Special needs files from the 2010–2012 National Health Insurance Research Database were referenced. Logistic and multiple regression analyses were performed on the influenza-vaccinated and non-vaccinated participants regarding their likelihood of contracting influenza and subsequent complications (namely pneumonia and influenza, acute and chronic respiratory diseases, acute cerebrovascular diseases, and heart diseases), likelihood of receiving short-term (1–3 months) or long-term (1–9 months) clinical treatment, use of hospitalization, and all-cause mortality.

    Results: Overall, this study comprised 114,712 participants, 33.3% of which were administered influenza vaccine. The control variables were age, sex, whether they are low-income households, comorbidity, history of clinical visits of Western medicine in the preceding year, and the use of hospitalization in the preceding year. In comparison with the non-vaccinated participants, the vaccinated participants did not exhibit a decrease in clinical medical usage and costs for influenza and its complications. However, those who had contracted influenza showed a decrease in clinical costs, revealing that the severity of the disease was reduced among these participants. Moreover, the vaccinated participants exhibited significantly lower use and costs of hospitalization and shorter length of hospital stay for short-term and long-term pneumonia, influenza, acute and chronic respiratory diseases, acute cerebrovascular diseases, and heart diseases than the non-vaccinated participants. Compared with the non-vaccinated participants, the vaccinated participants exhibited a significantly lower short-term and long-term all-cause mortality rate (25.4% and 23.5%, respectively).

    Conclusion: This study found that administering influenza vaccine to older adults with dementia profoundly reduced their likelihood of hospitalization and risk of death caused by influenza and complications. The government should encourage vaccination in this group of older adults to strengthen their resistance against influenza.
    Appears in Collections:[健康產業管理學系] 博碩士論文

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