[Pricing and uptake rate of public funded pneumococcal vaccination for the elderly in Japan].
OBJECTIVE
The number of municipalities that offer a pneumococcal pneumonia vaccine (PPV) to their aged inhabitants has been increasing. In this study, a complete count survey of the practice of municipality-organized PPV vaccination programs was carried out to explore co-payment/subsidy levels and uptake rates.


METHODS
A questionnaire inquiring into the price charged to the vaccinee, the subsidy provided by the municipality, the size of the target population, and the numbers of individuals vaccinated from 2001 to 2007 was sent to 63 municipal authorities which had organized PPV vaccination programs. Annual changes of co-payment/subsidy and uptake rates are examined with analysis of variance (excluding the year with n < or = 2).


RESULTS
The number of municipalities that provided a subsidy was 1 in 2001, 2 in 2002, 18 in both 2003 and 2004, 24 in 2005, 41 in 2006, and 56 in 2007. Average levels of subsidy were 3233 yen in 2003, 3225 yen in 2004, 3168 yen in 2005, 3158 yen in 2006, and 3351 yen in 2007. Average levels of co-payment are 3899 yen in 2003, 3928 yen in 2004, 3979 yen in 2005, 3891 yen in 2006 and 3672 yen in 2007. No significant differences were found among average levels of subsidy/co-payment between consecutive years (F = 0.195, p = 0.964/F = 0.271, p = 0.949). Average uptake rates by number of years since the beginning of the program (response rate 68.1%, 109/160) were 17.7% for the 1st-year, and 5.4%, 3.7%, 3.4%, 4.6% for the 2nd- to 5th-years, respectively. Statistically significant differences were observed between the 1st- and each of the following years (Dunnett T3, p < 0.001). Average uptake rates in the first year of the program (response rate 80.9%, 51/63) were 32.1% in 2003, 8.5% in 2005, 13.6% in 2006 and 16.5% in 2007. Significant differences were observed between 2003 and 2005 (Tukey's HSD, p = 0.03), and 2003 and 2006 (Tukey's HSD, P = 0.015).


CONCLUSIONS
Our results revealed levels of co-payment/subsidy and uptake rates of municipality-organized PPV vaccination programs for the first time.
Hoshi
Shu-Ling
SL
Department of Health Care Policy and Management, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan.
Kondo
Masahide
M
Okubo
Ichiro
I
D000368:Aged; D005380:Financing, Government / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D022242:Pneumococcal Vaccines / Q000191:economics*; D014611:Vaccination / Q000191:economics / Q000706:statistics & numerical data
D022242:Pneumococcal Vaccines