2006年全国乙型病毒性肝炎报告质量调查分析

目的全面了解网络直报模式下医疗机构乙型病毒性肝炎病例的报告质量，为进一步提高监测数据的质量提供理论依据。方法采取分层抽样方法在全国范围内抽取363家医疗机构开展调查。结果本次调查共收集乙肝病例13668例。乙肝病例报告率为72．47％。县及以上医疗机构报告率为73．83％，乡镇及社区级医疗机构为63．91％，两者差异具有统计学意义（P〈0．0001）。乙肝住院病例报告率为74．5696，门诊病例报告率为71．07％，差异具有统计学意义（P=0．003）。初诊的乙肝病例报告率为76．01％。病原携带者、假阳性病例及无法判定病例报告率为5214％。2006年1～9月份乙肝重复报告率为0．61％，2005—2006年跨年度重复报告率为1．42％，其中13．59％的重复报告卡片为病例在不同医院就诊而被重复报告产生。结论乙肝病例报告质量不容乐观，漏报、重复报告以及错误报告并存，这是全国乙肝病例常规监测中普遍存在的问题，为此，建议修订全国乙肝病例报告标准，规范乙肝病例报告程序，以进一步提高监测数据的准确性，为乙肝防治工作提供科学依据。

National investigation into and analysis of hepatitis B reporting quality in 2006

Objective To learn about the reporting quality of hepatitis B on the web-based reporting model in 2006, and to support theoretical basis for the funther improvement on the quality of hepatitis B surveillance data in China. Methods Based on stratified sampling, 363 medical facilities were selected to conduct the survey. Results Totally 13 668 valid individual cases of hepatitis B were collected in this survey. The reporting proportion of hepatitis B was 72.47%. The proportion was 73.83% for the county and above facilities, and that for the township level was 63.91%. The difference between them was significant （P 〈 0. 000 1 ）. The reporting proportion of inpatients was 74.56 % , and that of outpatients was 71.07 % . The difference between them was also significant （P = 0. 003）. The reporting proportion of hepatitis B cases, which were the first visit to a doctor, was 76.01%. The repeated reporting proportion from January to September in 2006 was 0.61% . For those which had been reported not only in the year of 2005 but also in 2006, the proportion was 1.42 % . There were about 13.59 % repeated cases arising from diagnosis in different hospitals and reported at the same time. Conclusions There is much to be improved in medical facilities as far as hepatitis B reporting quality, underreporting, repeated reporting and mistaken reporting are in existence simultaneously, which is also a common problem in the regular surveillance in China. The reporting standard of hepatitis B cases should be revised and the reporting process should be more standardized in order to make the quality of surveillance data better.