平顶山市医疗机构传染病报告质量影响因素调查

摘要:目的　了解平顶山市医疗机构传染病报告现状、找出影响传染病报告工作质量的因素，为制定干预措施、提高传染病报告质量提供依据。方法　采用随机抽样方法，对抽中的医疗机构传染病报告质量进行调查、对医务人员和网络直报人员进行现场问卷调查，运用多因素分析方法评估传染病报告质量及其影响因素。结果　共调查医疗机构82家，调查医务人员118人，网络直报员34人。查出传染病699例，漏报77例，迟报16例，漏报率最低为0，最高为26.67%，平均为11.02%，迟报率最低为0，最高为9.09%，平均为2.57%。卡片完整率、准确率和一致率分别为86.70%、90.89%和85.97%。不同学历（χ2＝7.5，P＝0.041）、专业（χ2＝8.095，P＝0.031）、所在医院级别（χ2＝13.822，P＝0.003）、医院分级（χ2＝8.203，P＝0.015）和地区（χ2＝26.07，P＜0.001）是影响医务人员传染病报告知识掌握情况的因素。是否接受过督导（OR＝0.043）、参加培训次数（OR＝0.535）、传染病知识的掌握情况（OR＝0.938）是影响传染病报告质量的主要因素。结论　平顶山市传染病报卡质量不高，地区差异较大，通过改善人员结构、转变培训方式、强化督导、落实责任等方式可进一步提高报告质量。同时应以建设医院信息化为契机，创新传染病疫情报告模式，以达到减少传染病病例漏报、提高报告及时性和报告质量的目的。

Investigation of influential factors of communicable diseases reporting quality in medical facilities in Pingdingshan

Abstract: Objective To investigate the situation about notifiable infectious disease report management, and to evaluate the report quality and its influencing factors, and to increase report quality. Methods The research collected information by simple random sampling. We carried out questionnaire survey on doctors and infectious disease reporters to evaluate the report quality and its influencing factors. Results A total of 82 medical institutions, 118 medical staff and 34 networker direct reporting staff were investigated. The communicable diseases, underreporting cases, delaying cases were 699, 77 and 16, respectively. The rate of underreporting was 0 to 26.67%, with an average of 11.02 %. The rate of delaying was 0 to 9.09%, with an average of 2.57%. The rate of complete cards, accuracy and consistent were 86.70%, 90.89% and 85.97% respectively. Different education (χ2=7.5, P= 0.041), professional (χ2=8.095, P=0.031), hospital level (χ2=13.822, P=0.003), hospital grade (χ2=8.203, P=0.015) and regional (χ2=26.07, P=0.000) were factors affecting the medical staffs to grasp the reported knowledge of infectious diseases. Whether received supervision (OR=0.043), training times (OR=0.535), knowledge of infectious diseases (OR=0.938) were the main factors affect the quality of reporting of infectious diseases. Conclusion The overall quality of reporting in Pingdingshan is not high. There are differences between different regions reporting. By improving the personnel structure, changing training methods, strengthening supervision and other ways, we can further improve the quality of reporting. The construction of hospital information system should be accelerated to reduce underreporting cases and to improve the timeliness and quality of reporting.