Financing Strategies of Influenza Vaccination in China

Study Overview
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Brief Summary
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This trial focuses on influenza vaccination among three recommended groups in China. Data concerning the economic burden of influenza-like illness (ILI), vaccine hesitancy, discrete choice experiment, immunization records and willingness to pay for vaccines will be collected via questionnaires, and the financing strategies of influenza vaccines in China will be further analyzed. Besides, the knowledge, attitude/belief and practice (KAP) of medical staff will also be asked in a supplementary questionnaire.

Detailed Description
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This trial focuses on influenza vaccination among three recommended groups in China, including children (aged between 6 to 59 months), the elderly (aged 60 years old or above), and adult patients with chronic diseases (aged below 60 years old). The questionnaires will collect data on the economic burden of influenza-like illness (ILI), vaccine hesitancy, discrete choice experiment, immunization records and willingness to pay for vaccines, and the financing strategies of influenza vaccines in China will be further analyzed accordingly. Besides the three recommended groups, vaccination and health care personnel will also be asked about their knowledge, attitude/belief and practice (KAP) in a supplementary questionnaire.

Official Title
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Influenza Vaccination Among Three Recommended Groups in China: Economic Burden, Vaccine Hesitancy, Discrete Choice Experiment, Immunization Records, Willingness to Pay and Financing Strategies

Conditions
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Influenza Vaccines, Influenza, Human, Cost of Illness, Health Knowledge, Attitudes, Practice, Immunization Programs

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: (For children group) children aged between 6 to 59 months. (For the elderly group) the elderly aged 60 years old or above. (For chronic disease patient group) adult patients with chronic diseases aged below 60 years old. (For medical staff) general practitioners and vaccination staff. Interviewees with informed consent. Exclusion Criteria: Those cannot be surveyed for physical reasons. Those with communication barriers. Those who do not agree to participate in the survey.

Ages Eligible for Study
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Minimum Age: 6 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Children<br>Interviewees are parents or grandparents of children aged between 6 to 59 months. | Other: No intervention<br>* This is an observational study without any interventions.<br>|
| Elderly<br>Interviewees are the elderly aged 60 years old or above. | Other: No intervention<br>* This is an observational study without any interventions.<br>|
| Chronic disease patients<br>Interviewees are adult patients with chronic diseases aged below 60 years old. | Other: No intervention<br>* This is an observational study without any interventions.<br>|
| Vaccination and health care personnel<br>Interviewees are vaccination and health care personnel in each study site. | Other: No intervention<br>* This is an observational study without any interventions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| economic burden of influenza-like illness (ILI) | Questions were designed in the questionnaire to ask the economic burden of influenza-like illness (ILI), including direct and indirect costs. Specifically, direct costs include inpatient cost (both out-of-pocket and reimbursed, range 0-100,000), hospitalization cost (both out-of-pocket and reimbursed, range 0-500,000), drug cost (both out-of-pocket and reimbursed, range 0-100,000), transportation cost (range 0-100,000), accommodation cost range (0-100,000) and food cost (range 0-100,000). Indirect cost include missed working days of the patients and their relatives/friends. | 2019.08-2019.09 | 
| willingness to pay | Questions were designed in the questionnaire to ask interviewees' willingness to pay for influenza vaccination. A value between 0 and 150 RMB will be randomly generated, and ask the respondent whether he or she is willing to pay for influenza vaccination. For example, one is asked Would you like pay 102 for influenza vaccination? If the answer is Yes, then he or she will be asked Would you like pay 112 for influenza vaccination? If the answer is No, then he or she will be asked Would you like pay 92 for influenza vaccination? The willingness to pay is then settled and recorded. Moreover, the proportion of vaccination cost paid by individuals will be asked (if others will be paid by health insurance and the government). | 2019.08-2019.09 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| vaccine hesitancy and immunization records | Immunization records of children were collected. Questions were designed in the questionnaire to evaluate the degree of vaccine hesitancy of interviewees. Respondents will be asked abound their confidence, convenience and complacency about vaccination of different vaccines (include influenza, Hib, PCV, Rota and chickenpox), so as to further explore the influencing factors of people's vaccination behaviors. | 2019.08-2019.09 | 
| financing strategies | Financing strategies will be further discussed according to literature review, government reports, and the results of willingness to pay. Literature review will be done to learn about the financing strategies of influenza vaccination all over the world. Government reports on basic public health financing will be an important evidence and reference. The results of willingness to pay from the questionnaire estimate the amount (0-150) and proportion (0-100%) an individual is willing to pay for influenza vaccination. Combining the three information sources, a supply-demand curve can be drawn to decide the optimal financing strategies of influenza vaccine, and the cross-region inequities in China will also be taken into consideration. | 2019.08-2019.09 | 
| discrete choice experiment | An extra questionnaire was specially designed for a small portion of randomly chosen interviewees to conduce discrete choice experiment. In the discrete choice experiment, different packages of vaccine will be given for respondents to choose from. These packages have different characteristics in terms of protection duration, vaccine cost, efficacy, safety and production place. In the experiment, participants are asked to choose one package from 10 pairs of packages (package A and package B) according to their own preferences. Their preferences (protection duration, vaccine cost, efficacy, safety and production place) will be calculated and ranked according to the experiment results. | 2019.08-2019.09 |