2009年甘肃省张掖市甘州区医疗机构法定传染病漏报及网络直报质量调查

目的掌握甘肃省张掖市甘州区传染病发病情况。了解医疗机构法定传染病报告质量,查找传染病网络直报中存在的问题与不足,进一步提高工作质量。方法采用分层抽样方法对全区150家医疗机构开展漏报调查。结果共抽查全区医疗机构1-10月乙、丙类传染病14种541例,总漏报率为13.68%、迟报率为3.64%、报卡完整率为90.02%、准确率为94.46%及两卡一致率为90.91%。丙类传染病漏报率高于乙类,差异无统计学意义。甲型病毒性肝炎、甲型H1N1流感、麻疹及包虫病未发现漏报,未分型肝炎、风疹、丙型病毒性肝炎、感染性腹泻、菌痢及肺结核等是漏报率较高的病种,风疹是迟报最多的病种。乡镇卫生院是传染病报告质量最高的医疗机构,村卫生所最差。不同级别医疗机构门诊、住院部及化验室漏报、迟报程度不同。绝大多数的漏报、迟报是由临床医生造成的。结论 2009年张掖市甘州区医疗机构传染病报告工作质量较前几年有较大提高,略好于全国平均水平。认真落实制度和措施,加强督导和培训是提高传染病报告工作质量的根本方法。

Survey of underreporting of notifiable communicable diseases and network direct reporting quality in medical facilities in Ganzhou district in Zhangye, Gansu province, 2009

Objective To understand the actual incidence of notifiable diseases and provide evidence for the disease control and prevention. Methods The underreporting survey was conducted in 150 medical facilities by stratified sampling. Results Totally 541cases of 14 class B and C communicable diseases from January to October in 2009 were surveyed. The total anderreporting rate was 13.68%, late reporting rate was 3.64%, completeness rate of reporting card was 90. 02%, accurate rate was 94. 46% and concordance rate was 90. 91%. The underreporting rate of class C communicable diseases was higher than class B communicable diseases, the difference was without statistical significance. No underreporting was found for hepatitis A, 2009 pandemic influenza A （H1N1）, measles and echinococcosis, The underreporting rates of unspecified hepatitis, rubella, hepatitis C, infectious diarrhea, bacillary dysentery and tuberculosis were high. The late reporting rate of rubella was highest. The quality of notifiable diseases reporting of township health centers was better than other medical facilities, especially the village health clinics. The underreporting and late reporting degrees varied by medical facilities at different level, and most underreporting was made by clinical doctors. Conclusion The quality of notifiable communicable diseases reporting in Ganzhou district in 2009 was obviously improved, which was a little higher than the average national level. Actual carrying out regulations and measures and strengthening the supervisor and training would be fundamental to increase the quality of notifiable communicable diseases reporting.