山西省医疗机构丙型肝炎病例报告数据质量核查分析

  目的  了解山西省部分医院丙型肝炎（丙肝）病例报告情况，发现存在的问题，提高丙肝报告质量。  方法  对2019年7月1日至2020年6月30日山西省 11个市51家医院报告的丙肝病例数据进行核查，以《丙型肝炎诊断》（WS?213－2018）为依据，根据急性丙肝病例报告正确率、儿童丙肝病例报告正确率、确诊丙肝病例报告正确率、丙肝病毒（HCV）的RNA阳性病例漏报率和报告正确率指标分析山西省部分医院丙肝报告质量。  结果  本次核查急性丙肝病例17例，报告正确率为35.29%；核查儿童丙肝病例24例，报告正确率为54.17%；核查确诊丙肝病例1324例，报告正确率为61.78%；核查HCV RNA阳性病例1037例，漏报率为6.36%，报告正确率为72.81%；三级医院丙肝儿童病例报告正确率高于二级医院，差异有统计学意义（χ2=10.752，P=0.002）；三级医院丙肝确诊病例报告正确率高于二级医院，差异有统计学意义（χ2=136.953，P<0.001）；三级医院HCV RNA阳性病例漏报率低于二级医院，差异有统计学意义（χ2=13.484，P<0.001）；部分医院仍然在报疑似病例。  结论  山西省部分医院的丙肝病例报告质量较低，特别是二级医院；建议通过逐级培训的方式统一卫生监督部门、医疗机构和疾控机构丙肝诊断报告标准，提高该省丙肝病例诊断报告质量。

Quality evaluation and analysis of hepatitis C report data of medical institutions in Shanxi province

  Objective  To understand the reporting of hepatitis C cases in some hospitals in Shanxi province, find out the existing problems and improve the quality of the reported data.   Methods  The data of hepatitis C cases were collected from 51 hospitals in 11 cities in Shanxi from July 1, 2019 to June 30, 2020. According to the diagnostic criteria of hepatitis C (WS 213－2018), the correct reporting rate of acute hepatitis C cases, the correct reporting rate of hepatitis C cases in children, the correct reporting rate of confirmed hepatitis C cases, the underreporting rate of HCV RNA positive cases and the correct reporting rate of HCVRNA positive cases were used to analyze the quality of hepatitis C reporting in some hospitals of Shanxi.   Results  For the 17 acute hepatitis C cases, the correct reporting rate was 35.29%; For the 24 hepatitis C cases in children, the correct reporting rate was 54.17%. For the 1324 confirmed hepatitis C cases, the correct reporting rate was 61.78%. For the 1037 HCV RNA positive cases, the underreporting rate was 6.36%, the correct reporting rate was 72.81%. The correct reporting rate of hepatitis C in children in class Ⅲ hospitals was higher than that in class Ⅱ hospitals, the difference was significant (χ2=10.752, P =0.002); The correct reporting rate of confirmed hepatitis C cases in class Ⅲ hospitals was higher than that in the class Ⅱ hospitals, the difference was significant (χ2=136.953, P<0.001). The underreporting rate of HCV RNA positive cases in class Ⅲ hospitals was lower than that in class Ⅱ hospitals, The difference was significant (χ2=13.484, P<0.001); Suspected hepatitis C cases were still reported in some hospitals.   Conclusion  The quality of hepatitis C case reporting in some hospitals in Shanxi was low, especially in class Ⅱ hospitals. It is suggested to standardize the reporting of hepatitis C in health supervision, medical treatment and disease control by the training at different levels.