2009-2011年江苏省传染病报告与管理工作质量评估及影响因素探讨

目的 评价江苏省综合性医疗机构传染病报告与管理质量,探讨不同类别、区域、级别医疗机构的分布情况,并对影响传染病报告与管理质量的因素展开探索性的分析,为传染病报告管理与评估工作提供参考。 方法 采用加权秩和比法对各检查机构进行综合评分和分档;利用分档结果,采用累积优势logistic回归分析影响传染病报告与管理质量的重要因素。 结果 将72家综合性医疗机构分为4档,各档间加权秩和比(WRSR)值差异均有统计学意义,说明分档合理。不同区域、级别、类别的医疗机构在各档分布上差异无统计学意义。多因素logistic回归结果提示,医疗机构各类登记本的项目设置、医疗机构应对异常信息的反应机制的设立以及传染病报告卡的填写质量对传染病报告与管理工作质量影响较大。 结论 卫生行政部门应不断健全疫情报告与管理制度,规范和完善门诊日志、出入院登记本和检验部门登记本中的项目设置,提升医务人员传染病报告卡的填写质量,以期进一步提升传染病报告质量。

Evaluation of reporting and management of communicable diseases in Jiangsu, 2009-2011

Objective To evaluate the quality of reporting and management of communicable diseases in general hospitals in Jiangsu province, explore the differences among different hospitals and provide evidence for the communicable disease reporting and management. Methods Weighted rank-sum ratio method was used to conduct comprehensive quality evaluation, and cumulative odds logistic regression was used to discuss the factors affecting the quality of reporting and management of communicable diseases. Results Seventy two hospitals surveyed were divided into 4 grades according to their reporting quality, the differences of WRSR among different grade hospitals were significant. The differences of grade division among hospitals of different type, at different area and at different class were not significant. The results of multivariate cumulative odds logistic regression indicated that the major factors affecting the reporting quality included item in hospital registrations, establishment of response mechanism for abnormal information and filling of communicable disease reporting cards. Conclusion The quality of reporting and management of communicable diseases can be evaluated comprehensively with WRSR method, follow-up analysis can be carried out with the WRSR results, so more detail and specific evidences can be provided for the health policy making.