北京市肺炎球菌疫苗免费接种政策对老年人肺炎住院的影响

目的  分析北京市肺炎球菌疫苗免费接种政策实施前后北京市老年人群肺炎住院情况的变化，评估该项政策对老年人肺炎防治的效果。方法  利用北京市城镇职工医疗保险数据库2014―2019年收集的老年人群住院数据，以2019年1月作为政策的干预分界点，应用中断时间序列模型(interrupted time series, ITS)分析政策实施前后北京市老年人群肺炎住院人次的变化。结果  免费接种政策实施前北京市≥65岁老年人因肺炎住院人次呈上升趋势(RR=1.019，P < 0.001)，政策实施后上升趋势有所减缓(RR=0.971，P=0.013)；敏感性分析中，≥65岁老年人因股骨骨折住院人次在政策实施前后则没有明显变化(RR=0.992，P=0.503)。结论  肺炎疫苗免费接种政策与老年人肺炎住院趋势减缓有一定关联，应进一步采取相关策略提高该疫苗的接种可及性。

Effect of the free pneumococcal vaccination policy on the hospital admissions for pneumonia among the elderly in Beijing

  Objective  To analyze the hospitalization trends for elderly pneumonia patients before and after implementing the free pneumococcal vaccination policy in Beijing, and to evaluate the policy's influence on the prevention and treatment of pneumonia in the elderly.  Methods  Monthly hospital admission data was obtained from Urban Employee Basic Medical Insurance (UEBMI) in Beijing from 2014 to 2019. The policy intervention cut-off point was set in January 2019. The interruption time series (ITS) model was used to analyze the changes of hospital admissions among elderly pneumonia patients in Beijing before and after implementing the policy.  Results  Before the implementation of the policy, the number of hospital admissions for pneumonia among people over 65 years old in Beijing showed an upward trend (RR=1.019, P < 0.001), and the trend slowed down after the implementation of the policy (RR=0.971, P=0.013). In the sensitivity analysis, there was no significant change in the number of hospital admissions for femoral fracture among people over 65 years old after the implementation (RR=0.992, P=0.503).  Conclusions  The free pneumococcal vaccination policy in Beijing is associated with the reduction of the risk of hospital admission for pneumonia among the elderly. Further strategies are needed to improve the accessibility of the vaccine.