Optimal Design of Population-Level Financial Incentives of Influenza Vaccination for the Elderly.
Value Health
; 23(2): 200-208, 2020 02.
Article
en En
| MEDLINE
| ID: mdl-32113625
ABSTRACT
OBJECTIVES:
To identify how monetary incentives affect influenza vaccination uptake rate using a randomized control experiment and to subsequently design an optimal incentive program in Singapore, a high-income country with a market-based healthcare system.METHODS:
4000 people aged ≥65 were randomly assigned to 4 treatment groups (1000 each) and were offered a monetary incentive (in shopping vouchers) if they chose to participate. The baseline group was invited to complete a questionnaire with incentives of 10 Singapore dollars (SGD; where 1 SGD ≈ 0.73 USD), whereas the other three groups were invited to complete the questionnaire and be vaccinated against influenza at their own cost of around 32 SGD, in return for incentives of 10, 20, or 30 SGD.RESULTS:
Increasing the total incentive for vaccination and reporting from 10 to 20 SGD increased participation in vaccination from 4.5% to 7.5% (P < .001). Increasing the total incentive from 20 to 30 SGD increased the participation rate to 9.2%, but this was not statistically significantly different from a 20-SGD incentive. The group of nonworking elderly were more sensitive to changes in incentives than those who worked. In addition to working status, the effects of increasing incentives on influenza vaccination rates differed by ethnicity, socio-economic status, household size, and a measure of social resilience. There were no significant differential effects by age group, gender, or education, however. The cost of the program per completed vaccination under a 20-SGD incentive is 36.80 SGD, which was the lowest among the three intervention arms. For a hypothetical population-level financial incentive program to promote influenza vaccination among the elderly, accounting for transmission dynamics, an incentive between 10 and 20 SGD minimizes the cost per completed vaccination from both governmental and health system perspectives.CONCLUSIONS:
Appropriate monetary incentives can boost influenza vaccination rates. Increasing monetary incentives for vaccination from 10 to 20 SGD can improve the influenza vaccination uptake rate, but further increasing the monetary incentive to 30 SGD results in no additional gains. A partial incentive may therefore be considered to improve vaccination coverage in this high-risk group.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Régimen de Recompensa
/
Vacunas contra la Influenza
/
Asignación de Recursos para la Atención de Salud
/
Aceptación de la Atención de Salud
/
Vacunación Masiva
/
Costos de los Medicamentos
/
Programas de Inmunización
/
Servicios de Salud para Ancianos
Tipo de estudio:
Clinical_trials
/
Evaluation_studies
/
Health_economic_evaluation
/
Prognostic_studies
/
Qualitative_research
Límite:
Aged
/
Female
/
Humans
/
Male
País/Región como asunto:
Asia
Idioma:
En
Revista:
Value Health
Asunto de la revista:
FARMACOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Singapur