中国县及县以上医疗机构2005年死亡病例漏报及报告质量评价

目的了解中国县及县以上医疗机构网络直报死亡病例的漏报情况,评价网络直报死亡病例的报告质量。方法使用分层随机抽样的方法在全国范围内抽取130家医疗机构开展调查,分别使用现场调查数据和网络直报数据评价医疗机构死亡病例漏报及其报告质量。结果2005年全国的县区报告率为78．25％,单位报告率为37．93％,与2004年相比略有下降;全国平均报告合格率为79．62％,比2004年有所提高;县及县以上医疗机构死亡病例有明显编码错误的比例为24．68％。现场调查共收集门诊、急诊、住院部死亡病例5226例,全国县及县以上医疗机构死亡病例总的漏报率为33．07％,不同级别医疗机构死亡病例漏报率的差异无统计学意义。结论全国县及县以上医疗机构死亡病例网络报告系统自运转以来,提高了数据报告的及时性,但也存在不足,如死亡病例存在缺漏报、及时性和编码准确性还有待提高,多系统并存工作重复的医院不在少数,应逐步建立全国统一的生命登记系统。

Study on the evaluation of underreporting and the quality of death cases reporting system, from medical intitutites at county level and above, in 2005

Objective To understand the underreporting on death cases through web-based reporting system from medical institutions at county level and above as well as to evaluate the quality of death cases reporting through the system. Methods A large-scale survey was conducted at 130 medical institutions based on stratified random sampling and to evaluate the underreporting and the quality of death cases reporting from medical institutions through data from survey and reporting system. Results In 2005, the total reporting rates were 78.25% at the county level and 37.93% at the institutes. Comparing with the results of 2004, these rates were going down slightly. The eligibility rate of reporting was 79.62% , increased when comparing with results of 2004. The percentage of obvious coding errors among deaths reported by county level and above medical institutions was 24.68%. A total of 5226 death cases were recorded from medical (outpatient and inpatient) sources. An average underreporting rate of 33.07% was found at the selected medical institutions. Statistical difference of underreporting rate was not found at medical institutions at different levels. Conclusion Since the initiation of the web-based reporting system of death cases at medical institutes from county level and above, the timeliness of data reporting had been increasing remarkably. The system showed irreplaceable advantages. However, there still existed some problems such as the underreporting of death cases, the poor timeliness of reporting,and the poor accuracy of coding. In the meantime,it was noticed that repetitive work existed among medical institutions due to multi-systems, suggesting that it was necessary to establish a national life registration in China.