2021年黄冈市医疗机构报告乙肝病例准确性评价研究  

Study on accuracy evaluation of hepatitis B cases reported by medical institutions in Huanggang in 2021

作　　者：王芬[1] 陈宇 韩凤情[1] 黄鑫胜 潘洁[1] 易磊 WANG Fen;CHEN Yu;HAN Fengqing;Huang Xinsheng;PAN Jie;YI Lei(Huanggang Center for Disease Control and Prevention,Hubei 438000,China)

机构地区：[1]黄冈市疾病预防控制中心,湖北438000

出　　处：《医学动物防制》2023年第3期302-305,共4页Journal of Medical Pest Control

基　　金：中国肝炎防治基金会中国乙肝防控科研基金(YGFK20180058);湖北省公共卫生青年拔尖人才项目(鄂卫通[2021]74号)。

摘　　要：目的调查分析2021年黄冈市医疗机构在国家法定传染病报告信息管理系统(national notifiable disease report system,NNDRS)报告的乙型病毒性肝炎(简称“乙肝”)病例重复报告情况,包括乙肝病例诊断、报告和分类诊断一致率,为今后提升疫情报告质量提供数据支持。方法采用分层随机抽样方法,根据黄冈市城市和农村各抽取2个县,按照不同医疗机构的级别随机抽取1个市级医疗机构,3个县级医疗机构,6个乡镇级医疗机构,在2021年第2季度开展乙肝病例监测。结果对842例NNDRS报告的乙肝病例复核,急性和慢性乙肝复核一致率分别为35.48%(11/31)和51.75%(414/800);县级医疗机构诊断符合率(67.52%)高于市级(46.88%)和乡镇级医疗机构(38.46%)。复核前后黄冈市医疗机构乙肝病例分型差异有统计学意义(χ^(2)=416.88,P<0.01)。导致乙肝病例诊断不符合的主要原因是67.40%的乙肝病原携带者被诊断为慢性乙肝病例网络报告(281/417)。2018—2021年乙肝病例报告平均年重复率为2.16%。医务人员对乙肝病例诊断和报告标准掌握度不高,仅34.97%的医务人员知道乙肝病毒携带者不需要网络报告。结论2021年黄冈市NNDRS乙肝病例报告准确性较低,存在重复报告、急慢性病例分类报告不准、乙肝携带者误报为慢性乙肝病例等情况,建议加大、加强医疗机构培训,填写“附卡”信息,提高乙肝病例诊断和报告准确性。Objective To investigate and analyze the repeated reports of hepatitis B cases from medical institutions in Huanggang in 2021 in the National Notifiable Disease Report System(NNDRS)by taking the consistent rate of hepatitis B case diagnosis,reporting and classified diagnosis into consideration,so as to provide data support for improving the quality of epidemic reporting in the future.Methods Using stratified random sampling method,1 county was selected from the urban area,and the other from the rural area of Huanggang.Besides,1 municipal medical institution,3 county-level medical institutions and 6 town-level medical institutions were randomly selected according to different levels of medical institutions to carry out hepatitis B case surveillance in the second quarter of 2021.Results Among 842 hepatitis B cases reported by NNDRS,the consistent rates of acute hepatitis B and chronic hepatitis B were 35.48%(11/31)and 51.75%(414/800),respectively.The diagnostic compliance rate of county-level medical institutions(67.52%)was higher than that of city-level medical institutions(46.88%)and township-level medical institutions(38.46%).And there was significant difference in the classification of hepatitis B cases in medical institutions in Huanggang City(χ^(2)=416.88,P<0.01)before and after the recheck.The main cause of nonconformity was that 67.4%of HBV carriers were diagnosed as chronic hepatitis B(281/417)and were reported online.The average annual repetition rate of hepatitis B reported from 2018 to 2021 was 2.16%.The medical staff have a poor grasp of the diagnostic and reporting standards of hepatitis B,and only 34.97%of them knew that hepatitis B virus carriers did not need to report online.Conclusion The accuracy of hepatitis B report in NNRDS in Huanggang in 2021 is low,and there are repeated reports,mixed reports of acute and chronic cases,false reports of hepatitis B carriers as chronic hepatitis B and so on.In order to improve the accuracy of diagnosis and report of hepatitis B,it is suggested to strengthen

关 键 词：乙肝 传染病报告 调查 准确性 评价 

分 类 号：R512.62[医药卫生—内科学]