臺灣社區老人接受流行性感冒疫苗注射的相關因素分析

Factors Associated with Receiving Influenza Vaccine Among Community-Dwelling Elderly in Taiwan

本研究目的在分析台灣社區老人流感疫苗接種與健康狀況、健康行為、居住安排以及醫療利用的關係。本研究利用「國民健康訪問暨藥物濫用調查」資料庫，選取65歲（含）以上老人為研究樣本共計2,688人，該調查使用多階段分層系統抽樣設計，因此具有全國代表性。統計方法採用卡方檢定與邏輯式迴歸分析。結果發現，台灣社區老人接種流感疫苗的比率為57.7％，在男性老人方面，「75～84 歲」（OR=1.24；95％ CI=1.09～1.41）、「與配偶同住」（OR=1.35；95％ CI=1.10～1.67）、「有主要慢性疾病」（OR=1.27；95％ CI=1.12～ 1.44）、「過去兩週內有運動」（OR=1.32；95％ CI=1.16～1.49）、「過去12 個月曾做過健康檢查」（OR=1.58；95％ CI=1.38～1.80）、「過去一個月有門診」（OR=1.21；95％ CI=1.07～1.37）者，其流感疫苗接種比率較高。在女性老人方面，「過去兩週內有運動」（OR=1.18；95％ C.I.=1.05～ 1.32）、「過去12 個月曾做過健康檢查」（OR=1.51；95％ C.I.=1.32～1.73）、「過去一個月有門診」（OR=1.27；95％ C.I=1.13～1.43） 者的疫苗接種比率較高。本研究指出「過去一個月曾看過門診」、「過去一年曾作過健康檢查」、以及「過去兩週有運動」者，是預測老人接種流感疫苗的重要相關因素，相對的，不運動、不作全身性健康檢查、與不接觸門診的老人，是未來社區宣傳與提升疫苗接種比率的重點。

The objective of this study was to investigate the relationship between influenza vaccination and health status, health behavior, living arrangement, and health care utilization for community-dwelling elderly in Taiwan. This study selected, by the multi-stage stratified systemic sampling design, elderly aged 65 and above (2,688 elderly in total) from the National Health Interview Survey (NHIS) of 2005 as a research sample, which represented senior citizens residing in Taiwan. Data on each subject’s influenza vaccination status in the previous year was collected by questionnaire. Chi-square and logistic regression were applied for statistical analysis. vaccine uptake in the overall sample was 57.7%. For male, factors associated with higher likelihood to take an influenza vaccine were: those aged between 75 and 84 (OR=1.24; 95% CI=1.09~1.41), living with spouse (OR=1.35; 95% CI=1.10~1.67), having chronic diseases (OR=1.27; 95% CI=1.12~ 1.44) , doing exercise during last two weeks (OR=1.32; 95% CI=1.16~1.49), having a health examination during last 12 months (OR=1.58;95% CI=1.38~1.80), and making outpatient visits for last month (OR=1.21; 95% CI=1.07~1.37). For female, those factors were: doing exercise (OR=1.18; 95% CI=1.05~1.32), having a health examination (OR=1.51; 95% CI=1.32~1.73), and making outpatient visits for last month (OR=1.27; 95% CI=1.13~1.43). Vaccine uptake was significantly associated with factors like doing exercise during last two weeks, having a health examination during last 12 months, and having outpatient visits for last month. Therefore, those who were not doing exercise, having no health examination, and not making outpatient visits should be targeted for health promotion interventions aiming to improve their influenza vaccination uptake rate.