2005年全国医疗机构法定传染病漏报情况调查分析

目的了解我国医疗机构法定传染病的漏报情况,为进一步提高传染病网络直报工作效率和质量提供理论依据。方法使用分层抽样的方法在全国范围内抽取250家医疗机构开展大规模调查。结果本次调查共收集门诊、住院部和化验室传染病个案13 714例。全国医疗机构传染病总的漏报率为23.14%,其中甲、乙、丙类传染病漏报率分别为0、23.64%和21.37%。漏报率最高的前5种传染病依次为丙肝(51.68%)、风疹(47.73%)、流行性感冒(47.06%)、AIDS(39.62%)、急性出血性结膜炎(36.84%)。医疗机构中门诊、住院部、化验室传染病漏报率依次增高,分别为19.86%、25.44%和35.78%。不同级别医疗机构传染病漏报率的差异也有统计学意义,其中省级医疗机构传染病漏报率为23.25%、地市级20.24%、县区级26.23%、乡镇级24.12%。结论我国医疗机构传染病报告工作不容乐观。各级各类医疗机构应树立医防结合的工作理念,重视传染病疫情报告工作,加强医疗机构传染病疫情报告工作的规范化管理。各级卫生行政部门应定期组织对本辖区医疗机构传染病疫情报告管理工作的监督检查。

An investigational analysis of missing reports of notifiable diseases in medical facilities all over China in 2005

Objective The present analysis was conducted to know the missing reports of notifiable diseases in medical facilities all over China in order to provide a theoretical basis for further improving the efficiency and quality of direct network reports of infectious diseases.Methods Based on stratified sampling,250 medical facilities were selected from all over the country to conduct a large-scale survey.Results A total of 13714 cases of infectious diseases were collected from outpatient and inpatient departments and laboratory sources.It was found that the average missing report rate was 23.14% in medical facilities all over the country,with the missing report rates of class A,B and C notifiable diseases being 0,23.64% and 21.37%,respectively.The top five infectious diseases with highest missing report rates were in turn hepatitis C(51.68%),rubella(47.73%),influenza(47.06%),AIDS(39.62%)and acute hemorrhagic conjunctivitis(36.84%).The rates of missing reports on infectious diseases in outpatient,inpatient and laboratory departments were 19.86%,25.44% and 35.78%,respectively.Statistically there were significant differences in the missing report rate between medical facilities at different levels,with the rate being 23.25%,20.24%,26.23% and 24.12% in the facilities at provincial,prefectural,county and township levels respectively.Conclusion There is much to be improved in medical facilities in China as far as reporting of infectious diseases is concerned.The reporting of epidemic situations of infectious diseases should be taken seriously in various medical facilities at different levels with the idea of treatment in combination with prevention in mind.The health authorities at all levels should regularly organize supervision and inspection on the reporting of epidemic situations of notifiable diseases in medical facilities within the areas under their jurisdiction,strengthening their standardized management of the reporting of epidemic situations of notifiable diseases.