湖南省2007年医疗机构法定传染病漏报调查

目的了解湖南省医疗机构法定传染病漏报情况，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。方法使用分层抽样方法在全省范围内抽取161家医疗机构开展调查。结果本次共调查门（急）诊、住院部和化验室传染病病例28891例。全省医疗机构传染病总漏报率为4．19％，报告卡合格率为92．21％。其中甲、乙、丙类传染病漏报率分别为0、4．21％和4．02％。漏报率最高的前5种传染病依次为钩体病（15．79％）、甲肝（14．84％）、百日咳（11．11o,6）、风疹（9．66％）和流行性腮腺炎（7．02％）。医疗机构中住院部、化验室、急诊和门诊传染病漏报率依次增高，分别为3．72％、4．51％、6．20％和6．92％。县及以上级别医疗机构与乡镇卫生院传染病漏报率的差异有统计学意义，其中省级医疗机构传染病漏报率为22．84％、地市级6．85％、县区级3．59％、乡镇级9．90％。结论湖南省医疗机构传染病报告工作有所进步，但仍然存在差距，各级各类医疗机构特别是乡镇级和省级应加强传染病疫情报告工作，强化传染病疫情报告工作的规范化管理。

Analysis on Missing Reports of Notifiable Diseases in Medical Institutions in Hunan Province in 2007

Objective To know the missing reports of notifiable diseases in medical institutions in Hunan Province,and to provide a theoretical basis for further improving the efficiency and quality of direct network reports of infectious diseases.Method By stratified sampling,161 medical institutions were investigated in Hunan Province to conduct a large-scale survey.Results A total of 28,891 cases of infectious diseases were investigated from departments of outpatient,emergency,inpatient,and laboratory.The average missing report rate was 4.19%,the average qualified rate of reports' card was 92.21%.The missing report rates of class A,B and C notifiable diseases were 0,4.21% and 4.02%,respectively.Leptospirosis(15.79%),rubella(9.66%),parapertussis(11.11%),viral hepatitis A(14.48%),and epidemic parotitis(7.02%)were the top five kinds of infectious diseases those missing report rates were higher.The missing reports rates on infectious diseases in departments of inpatient,laboratory,emergency and outpatient were 3.72%,4.51%,6.20%,and 6.92%,respectively.The missing report rates were 22.84%,6.84%,3.59% and 9.90% in the facilities at provincial,prefectural,county and township levels,and there were significant differences among different levels medical institutions.Conclusions There is much to be improved in medical institutions in Hunan Province as far as reporting of infectious diseases is concerned.The reporting of epidemic situations of infectious diseases should be taken seriously in various medical institutions at different levels.The medical facilities at all levels,especially provincial and township levels should regularly organize training on the reporting of notifiable diseases,and strengthen the standardized management of the reporting of epidemic situations of notifiable diseases.