二类疫苗纳入深圳市社会医疗保险支付范围的定性研究

目的 了解目前深圳市二类疫苗纳入社会医疗保险支付范围的可行性,分析存在的问题,为深圳市制定及完善相关政策提供参考.方法 通过定性研究的方法,对深圳市、区疾控机构和社区健康服务中心免疫管理人员进行半结构式个人深入访谈,对访谈结果进行归类分析.结果 75%访谈对象认为二类疫苗应纳入社保支付范围,所有访谈对象认为二类疫苗的资金来源是影响二类疫苗纳入社保支付的主要问题,其次50%访谈对象认为政策覆盖人群也是问题之一;67%访谈对象认为应该根据人群所参与的社保类型,成熟先行,分类分步实施,即社保支付二类疫苗费用,综合医保人群可先推行,住院、少儿和农民工医保人群暂缓推行.结论 二类疫苗应分类、逐步纳入社保支付范围,同时探索公共卫生服务与社保之间的关系,建立一种合理的运行体制.

Qualitative Study on the Extra EPI Vaccine Covered by Social Medical Insurance in Shenzhen City

Objectives To understand the feasibility of the Shenzhen extra EPI vaccine covered by social medical insurance （SMI） and to analyze current problems in order to provide references for policy-making in Shenzhen. Methods A semi- structured interview was conducted among immune staffs from centers for disease control and prevention from municipal and county level and the community health service centers in Shenzhen. Results were analyzed in categories. Results 75% interview respondents thought the extra EPI vaccine should be covered by SMI in Shenzhen. All respondents thought the main problem for Shenzhen extra EPI vaccine to be covered by respondents was the source of funds for extra EPI vaccine. And 50% of the respondents thought the coverage span of population for this policy was also a problem. 67% of the respondents suggested that extra EPI vaccine covered by SMI should he carried out based on the type of people＇s social insurance and step by step. They thought people with general medical insurance could get the extra EPI vaccine covered by SMI first, while people with medical insurance targeting inpatients, children and migrant workers could wait. Conclusions Extra EPI vaccine covered by SMI should be ineluded in SMI stage by stage. Meanwhile, a reasonable operation system should be established based on exploration of the relationship between public health and SMI.