法定传染病网络报告系统质量评价指标体系评价

目的 对中国法定传染病网络报告信息系统2004年以来报告质量评价指标体系进行评价。方法 汇总2004-2013年年度和月度质量评价分析结果,结合系统中医疗卫生机构报告的卡片信息、现场调查的传染病报告质量和标准编码管理系统中的机构信息等对系统报告质量评价的指标体系与结果进行综合分析和讨论。结果 全国月均县(区)零缺报率2006-2010年呈下降趋势,到2010年全国只有2个县为零报告;网络报告率整体逐年上升,2012年最高为95.39%;2013年网络正常运行率为99.10%,但因系统维护的机构有限,仍不能回答系统对全国各级各类医疗卫生机构的覆盖面问题。医疗机构诊断到报告的及时性在2006-2013年间逐年提高,2013年月均及时报告率为99.75%,但系统填报的诊断时间与实际诊断时间的准确率和一致率较低。疾病预防控制机构报告到审核的及时性在2006-2013年间逐年提高,2013年月均及时审核率为99.89%,但审核确认的卡片信息中仍存在信息缺漏报、逻辑错误、年龄与职业不符、诊断分类与诊断标准和报告规范不一致等问题。月均重复报告卡数在2006-2013年间逐年减少,重卡比例下降,2013年仅0.0012%,但不同原因造成的卡片信息的误差使系统可甄别的重卡大幅减少。结论 系统的报告质量评价指标体系很好地涵盖了系统的覆盖面以及数据收集、管理的全过程,指标的统计方式也在不断完善,但对系统报告数据的质量需要开展相关现场调研来评价。

Evaluation on quality index system for notifiable communicable diseases network reporting

Objective To evaluate the quality index system for internet based notifiable infectious disease reporting in China since 2004. Methods The monthly and annual evaluation data from 2004 to 2013 was collected, then card information in the reporting system, field investigation of report quality and organization codes in standard coding management system were combined for comprehensive analysis and discussion. Results The average monthly miss report rate in counties showed a downward trend during 2006-2010, and only two counties had no report in 2010. The overall reporting rate of major infectious diseases was in increase and reached the highest: 95.39% in 2012. The rate of normal operation of the network was 99.10% in 2013, but to the limited maintenance facilities, this indicator could not reflect the coverage of network reporting system on national medical institutions. The timeliness of medical diagnosis reporting increased year by year during 2006-2013 and the average monthly timely reporting rate was 99.75% in 2013. The consistent rate between the diagnosis time and reporting time was low. The timely verifying rate of the report increased year by year during 2006-2013, the average monthly verifying rate was 99.89% in 2013. But problems still existed in some verified reporting cards, such as information miss, logic errors, mis-filling of age or occupation, diagnostic classification in consistent with diagnostic criteria and standards, etc. Monthly repeated reporting cards decreased year by year during 2006-2013 and the proportion of repeated reporting cards decreased to 0.0012% in 2013. The repeated cards which system recognized automatically declined due to the errors in the cards. Conclusion The quality evaluation index system well covered the area of data collection and management, and statistical methods of evaluation index were also constantly improved. The relevant field research was still needed to evaluate the quality of reporting data in the system.