我院2009-2011年国家基本药物使用情况分析

目的：了解广东省人民医院国家基本药物的使用现状,并为进一步促进我院国家基本药物合理应用提供依据。方法：对我院2009--2011年国家基本药物品种覆盖率、使用金额比例、用药频度（DODs）进行调查、分析。结果：我院2009—2011年国家基本药物使用品种数分别是164、166、169种,占国家基本药物目录的构成比分别是53．4％、54．0％、55．0％;2009—2011年我院国家基本药物使用金额分别是5531．36万元、3390．35万元和4390．69万元,占医院药品销售额比例分别为4．73％、2．58％和1．67％。我院2009--2011年国家基本药物DDDs排序前3位的分别是辛伐他汀片、沙丁胺醇喷雾剂、二甲双胍片。结论：我院2009—2011年国家基本药物使用品种数较稳定,但品种覆盖率、使用金额及比例均偏低,远未达到国家要求,还有待进一步改进。     

积极生育支持背景下不孕不育医疗保障政策国际比较研究

本文基于全民健康覆盖框架,从人群覆盖广度、服务覆盖宽度和费用覆盖深度三个维度,比较了12个国家的不孕不育医疗保障政策异同与效果。为全面构建积极生育支持体系,应针对我国不孕不育高发、医疗费用高昂的社会人口问题,借鉴国际经验,完善不孕不育医疗保障顶层设计,构建多层次保障体系;明确覆盖患者的纳入标准;动态调整医疗服务清单;综合考虑政策目标、筹资能力和患者需求等因素科学制定适宜费用保障标准。多元协同为不孕不育患者提供充分的经济支持,推动实现适度的生育水平。     

2008年资阳市麻疹疫苗强化免疫活动分析

目的总结麻疹疫苗（MV）强化免疫经验,加速麻疹控制,如期实现消除麻疹目标。方法收集资阳市MV强化免疫报表数据,采用描述性方法对相关数据进行流行病学分析。结果本次MV强化免疫共计接种8月龄．14岁目标儿童663992人,报告接种率和快速评估接种率均〉95％;麻疹强化免疫后麻疹发病大幅下降。结论本次MV强化免疫达到了预期目的。     

Vaccination coverage rates for Diphtheria,Tetanus, Poliomyelitis and Pertussis booster vaccination in France between 2013 and 2017: Learnings from an analysis of National Health System Real-World Data

BackgroundMaintaining a high vaccination coverage rate (VCR) throughout the lifetime and complying with the National Immunization Program are essential to optimize the protection of the population. The study objectives were to evaluate the evolution of the VCRs and the compliance with the vaccination visits for the diphtheria, tetanus, poliomyelitis and pertussis boosters in France since the changes implemented in the 2013 National Immunization Program.MethodsCumulative booster VCRs were estimated at all vaccination visits, from 2013 to 2017, among persons eligible for a booster vaccination from a 1/97th random sample of French claims data. Broader age groups around the recommended ages by the vaccination schedule (6, 11–13, 25, 45, 65, 75, 85, 95y) were used: all persons aged 5 to 8, 10 to 15, 21 to 29, 41 to 49, 61 to 69, 71 to 79, 81 to 89 and 91 to 99.ResultsOver the study period, the diphtheria-tetanus-poliomyelitis booster VCRs increased, reaching in 2017: 73.3% at 8 years old, 75.6% at 15 years old, 46.6% at 29 years old, 38.4% at 49 years old, 36.3% at 69 years old, 30.8% at 79 years old, 22.1% at 89 years old and 11.0% at 99 years old. The pertussis VCRs were also increasing at all vaccination visits, in particular at the vaccination visits at 6 and 11–13 years old (from 16.4% to 63.8% and from 50.3% to 61.2%, respectively). Delayed vaccinations were observed at all vaccination visits.ConclusionVCRs for Diphtheria, Tetanus, Poliomyelitis and Pertussis booster vaccination increased from 2013 to 2017 while remaining suboptimal across all ages and lower in the adult populations. The analysis also shows that the introduction in 2013 of a pertussis vaccination at 6 years of age was relatively well-established in 2017 while other changes in recommendations were slowly or partially implemented.     

张家港市儿童接种乙型肝炎疫苗后乙型肝炎病毒表面抗原携带情况观察

为进一步完善乙型肝炎 (乙肝 )预防措施提供依据 ,采用整群随机抽样方法 ,抽取 1992～ 2 0 0 0年出生的儿童194 2名 ,对接种乙肝疫苗后儿童的乙肝病毒表面抗原 (HBsAg)携带情况进行调查。结果显示 :1992～ 2 0 0 0年出生儿童其乙肝疫苗接种率为 95 5 2 % ,HBsAg携带率为 1 34% ,其中有免疫史和无免疫史儿童的HBsAg阳性率分别为 1 0 8%和 6 90 % ,免疫组的保护率为 84 35 % ,无乙肝疫苗免疫史的儿童多为流动儿童     

做好计划免疫工作 提高适龄儿童预防接种率

有计划地利用疫苗进行适龄儿奄预防接种,以提高人群免疫水平,达到控制以至最终消灭相应传染病。做好寅传教育,规范操作程序,按照科学免疫程序进行预防接种,提高接种质量。改进措施,提高接种率。     

Pneumococcal vaccine coverage in Japan among patients with a history of splenectomy: Results of a retrospective administrative database study

BackgroundSplenectomy results in immune deficiency and increases the risk of clinically significant infections, termed overwhelming post-splenectomy infection (OPSI). In Japan, vaccination with the 23-valent pneumococcal polysaccharide vaccine (PPSV23) is covered by the Japanese National Health Insurance (NHI) for post-splenectomy patients, but there are limited data about whether these patients receive PPSV23 vaccination.MethodsWe performed retrospective analyses of the JMDC Claims Database comprising employees (including some retired individuals) and their families in Japan. We identified patients who underwent splenectomy (registration period: January 1, 2005–June 30, 2019) at ≥ 2 to ≤ 64 years old, and obtained information about PPSV23 vaccination, reasons for splenectomy, and prevalence/complications of pneumococcal infectious diseases (including OPSI-related disorders).ResultsAmong 7,394,182 registered individuals, splenectomy was performed in 475, with an incidence rate of 1.6 cases per 100,000 person-years. Of 414 patients who underwent splenectomy at ≥ 2 to ≤ 64 years of age, their mean ± standard deviation age was 45.4 ± 15.7 years and 63.3% were 45–64 years old. Splenectomy was incidental in 55.3%. Overall, 123/414 patients were prescribed PPSV23 vaccination, resulting in vaccination coverage of 29.7%. The median interval from splenectomy to vaccination was 1.0 month (range: –1 to 85 months).ConclusionThis was the first study to document PPSV23 vaccination coverage after splenectomy in a Japanese real-world setting. PPSV23 coverage is quite low in Japan relative to that in other countries.     

Confidence sets for the break date based on optimal tests

In this paper, we propose constructing a confidence set for the date of a one‐time structural change using a point optimal test. Following Elliott and Müller (2007, Journal of Econometrics 141, 1196–1218), we first construct a test for the break date that maximizes the weighted average of the power function. The confidence set is then obtained by inverting the test statistic. We carefully choose the weights and show by Monte Carlo simulations that the confidence set based on our method has a relatively accurate coverage rate, while the length of our confidence set is significantly shorter than the lengths proposed in the literature.     

全国碘盐监测简化方案的可行性研究

目的 对现有全国碘盐监测方案提出简化办法并探讨简化方案的可行性.方法 选取碘盐覆盖率不同水平的4省8县市,同时按照现行方案和简化方案开展碘盐监测,调查居民户碘盐覆盖情况.对两方案的结果进行比较,对简化方案的可行性进行分析.结果 现行方案监测居民户盐样2306份,碘盐覆盖率88.1%,合格碘盐食用率84.8%;简化方案监测居民户盐样2400份,碘盐覆盖率85.2%,合格碘盐食用率79.8%.两种方案监测宁化、沙县、瓦房店、庄河和民乐县碘盐覆盖率与合格碘盐食用率均＞90%,差异无统计学意义;临夏、乌兰和都兰县水平相对较低,其中都兰县碘盐覆盖率、合格碘盐食用率和临夏县的合格碘盐食用率两方案的结果差异均有统计学意义(P＜0.01).总体样本两方案结果差异也有统计学意义(P＜0.01).结论 简化方案具有较好的可操作性,在碘盐覆盖率较高地区具有一定推广意义;而对非碘盐率较高、分布不均匀的地区及全国整体水平上,简化方案和现行方案间差异显著,尚不适宜推广.