2004—2017年兰州市伤害监测工作现状分析

目的分析2004-2017年甘肃省兰州市伤害监测报告现状,探讨报告过程中存在的主要问题及其原因,为制定伤害预防规划提供科学依据。方法 2018年以访谈形式收集伤害监测、报告和管理相关信息,采用自行设计调查表,由统一培训的调查员现场调查。结果 2004年兰州市建立了伤害监测工作组织机构,选定6家医院开展监测工作,通过几年的探索和调整,2008年数据质量达到监测要求,截止2017年共收集伤害病例176 310例,建立了兰州市伤害监测数据库;报告男女性别比为2∶1,年龄集中在18岁~组(占44.92%)和41岁~组(占32.42%);主要伤害原因为跌倒/坠落(32.61%),也是兰州市老年人和儿童伤害发生的首要原因;医护人员对伤害监测相关知识完全不知晓0人,知道一点但不确切的占14.57%;医护人员不赞同医院应当承担伤害等疾病信息收集和报告职责占20.86%,阻碍伤害监测报告工作的因素为主观不重视(7.71%)、院内缺乏相关技能跟进培训(61.43%)、岗位及人员变化(40.57%)、工作忙没时间(47.43%)和病人及家属不配合(9.43%)。结论由于医护人员公共卫生意识不强、岗位变动、培训不到位及诊疗工作忙等原因,兰州市伤害监测系统目前仍存在漏报和错报现象,建议规范报告流程、报告制度,加强人员培训、质量控制,完善伤害监测网络建设,提高监测质量。

Analysis of current situation of injury surveillance in Lanzhou from 2004 to 2017

Objective To analyze the status of injury reported in Lanzhou city from 2004 to 2017, explore the major problems and its causes in the reporting process of injury, and provide basic data and scientific basis for formulating prevention program of injury. Methods An interview survey was conducted for collecting information of injury surveillance, report and management in 2018. The questionnaire was self-designed and filled in by the investigators after training. Results The management organization of injury surveillance was set up and 6 hospitals were selected for injury surveillance in Lanzhou city in 2004. The quality of surveillance data reached the requirement in 2008 after several years’ exploration and adjustment. By 2017, there were 176 310 cases of injury collected in the database of injury surveillance in Lanzhou. The ratio of the male cases to the female was 2∶1, and the injury cases concentrated in the age group of 18-years and 41-years, with the proportion of 44.92% and 32.42%, respectively. The main reason for injury was falling/dropping(32.61%), which was the primary injury cause of the children and elder people. No medical workers knew nothing about relevant knowledge about injury surveillance, 14.57% of them knew a little but not sure, 20.86% thought that the hospital should not collect and report the information of injury and other diseases. The factors hintered the injury surveillance and report was subjective indifference(7.71%), lack of skill training(61.43%), personnel change(40.57%), medical workers busy with work(47.43%) and patient or the family members without cooperation(9.43%), respectively. Conclusions The miss reporting and misstatement still exist in the injury surveillance system of Lanzhou at present because of weak public health awareness, workers change, lack of training and busy with work. It is suggested that the surveillance process and reporting regulation be normalized, relevant training and quality control be strengthened, and the network of injury surveillance be perfect to improve the quality of surveillance.