title: Who benefits most from influenza vaccination policy: a study among the elderly in Beijing, China.
abstract: BACKGROUND
  Influenza continues to have a major impact on vulnerable populations worldwide, particularly among the elderly (≥ 60 years of age). Vaccination for targeted groups is recommended by the WHO as the most effective way to control influenza infections. Since 2009, the Beijing municipal government has provided influenza vaccination to the elderly at no out-of-pocket cost to reduce influenza threats and improve related health equality. The study aims to evaluate the equality of the policy, and to analyze factors that bring influences to equality.
  
  
  METHODS
  Based on data from a household survey, concentration index (CI) was calculated to measure the socioeconomic inequality in influenza vaccination. A Logit regression model was used to decompose CI, in which the contribution of each determinant was calculated and the percentages of these contribution were obtained.
  
  
  RESULTS
  Free influenza vaccination at point of use shows significant pro-poor distribution among the elderly in Beijing (CI = -0.115). After the decomposition of CI, the elderly with lower income, higher education, and living in rural areas were more likely to get the influenza vaccination, in which place of residence (contribution percentage = 57 %) held the most contribution of variance.
  
  
  CONCLUSIONS
  Beijing's free influenza vaccination strategy at point of use could provide the poor elderly with equal opportunities to receive preventive health service, showing a significant pro-poor distribution. The poor elderly, who live in rural areas with high education, benefit most from the policy. Further policy interventions should target the population living in urban areas in order to improve the utilization of public health services and health equality.
authors.affiliation: School of Public Health, Peking University, Beijing, 100191, P.R. China.
authors.forename: Tongtong
authors.initials: T
authors.lastname: Li
authors.affiliation: Beijing Center for Disease Prevention and Control, Beijing, 100013, P.R. China.
authors.forename: Min
authors.initials: M
authors.lastname: Lv
authors.affiliation: Columbia University Mailman School of Public Health, New York, 10032, USA.
authors.forename: Trudy
authors.initials: T
authors.lastname: Lei
authors.affiliation: Beijing Center for Disease Prevention and Control, Beijing, 100013, P.R. China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Wu
authors.affiliation: Beijing Center for Disease Prevention and Control, Beijing, 100013, P.R. China.
authors.forename: Xinghuo
authors.initials: X
authors.lastname: Pang
authors.affiliation: Beijing Center for Disease Prevention and Control, Beijing, 100013, P.R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Deng
authors.affiliation: School of Public Health, Peking University, Beijing, 100191, P.R. China. xiezheng@bjmu.edu.cn.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Xie
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000068476:Beijing / Q000453:epidemiology; D005102:Health Expenditures / Q000706:statistics & numerical data / Q000639:trends*; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D032521:Immunity, Herd; D007252:Influenza Vaccines / Q000627:therapeutic use*; D032541:Mass Vaccination / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D007252:Influenza Vaccines