2021年广西医疗机构法定传染病报告质量评价及影响因素分析  

Evaluation and influencing factors of the reporting quality of notifiable communicable diseases in medical institutions in Guangxi,2021

作　　者：宫晨[1] 唐洁霞 邓革红[1] 覃奕 韩姗珊 杨继[1] 吕炜[1] GONG Chen;TANG Jie-xia;DENG Ge-hong;QIN Yi;HAN Shan-shan;YANG Ji;LV Wei(Information Management Section,Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning,Guangxi 530028,China)

机构地区：[1]广西壮族自治区疾病预防控制中心信息管理科,广西南宁530028

出　　处：《现代预防医学》2023年第12期2215-2220,共6页Modern Preventive Medicine

基　　金：广西壮族自治区疾病预防控制中心资助青年科技工作者科研课题(202007)。

摘　　要：目的 了解广西医疗机构法定传染病信息报告质量,为进一步提高网络直报水平提供依据。方法 采用多阶段分层抽样方法抽取广西56家医疗机构,现场调查其传染病管理工作情况及法定传染病病例报告质量,应用R 4.2.1软件拟合log-binomial回归模型,分析传染病报告质量的影响因素。结果 本次共抽查医疗机构门诊和住院的法定传染病病例1 360例,查阅纸质传染病报告卡777张,法定传染病报告率95.88%、及时报告率97.93%、完整率97.43%、准确率67.37%、一致率90.09%、有效证件号填写完整率93.44%。不同级别医疗机构的报告率、及时报告率、一致率、有效证件号填写完整率差异均有统计学意义(P<0.05)。多因素log-binomial回归分析结果显示,门诊日志填写规范(PR=1.33, 95%CI:1.08~1.64)、落实自查工作(PR=1.45, 95%CI:1.08~1.95)、配备2人及以上传染病报告管理人员(PR=2.57, 95%CI:1.67~3.96)均能提高法定传染病报告率;电子病历系统具备传染病自动提醒报卡功能(PR=1.41, 95%CI:1.12~1.77)可以提高及时报告率;出入院日志填写规范(PR=1.57, 95%CI:1.17~2.11)、落实自查工作(PR=2.00, 95%CI:1.36~2.94)可以提高完整率;电子病历系统具备报告卡自动生成功能(PR=2.31, 95%CI:1.78~3.00)可以提高准确率。结论 广西法定传染病报告率达到了国家要求的95%以上,但仍然存在漏报且报告卡填写准确率较低。临床医生规范填写门诊日志/出入院日志、院内落实自查工作、完善电子病历系统传染病报告管理功能、配备数量充足的传染病报告管理人员是进一步提升传染病报告质量的有效措施。Objective To evaluate the quality of notifiable communicable diseases reporting in Guangxi, and to provide evidence for the improvement of network direct reporting of communicable diseases. Methods Through multistage stratified sampling, 56 medical institutions in Guangxi were selected in this survey. Management and reporting quality of notifiable communicable diseases in medical institutions were investigated, and log-binomial regression analysis was conducted with R-4.2.1 software. Results A total of 1 360 cases were surveyed. The reporting rate was 95.88%, the reporting timeliness rate was 97.93%, the completeness rate and accuracy rate of reporting cards were 97.43% and 67.37%, the concordance rate was 90.09%, and the complete rate of valid certificate numbers was 93.44%. The differences of reporting rate, reporting timeliness rate, concordance rate and complete rate of valid certificate numbers among medical institutions in different levels were statistically significant(P0.05). Results of multivariate log-binomial regression analysis indicated that filling standardized in outpatient record(PR=1.33, 95%CI:1.08-1.64), self-check(PR=1.45, 95%CI:1.08-1.95) and more than 2 reporting management staff(PR=2.57, 95%CI:1.67-3.96) could improve the reporting rate. Electronic medical record system(EMR) with automatic reminder reporting function(PR=1.41, 95%CI:1.12-1.77) could improve the reporting timeliness rate. Filling standardized in inpatient log(PR=1.57, 95%CI:1.17-2.11) and self-check(PR=2.00, 95%CI:1.36-2.94) could improve the completeness rate. Function of generating electronic cards automatically(PR=2.31, 95%CI:1.78-3.00) could improve the accuracy rate. Conclusion The reporting rate of notifiable communicable diseases in Guangxi is more than 95%, but there is still underreporting, and the accuracy rate is lower. It is necessary to improve the reporting quality in Guangxi by filling standardized diagnosis record, self-check, improving reporting management function of EMR, and assigning more than 2 reporting m

关 键 词：医疗机构 法定传染病 报告质量 影响因素 

分 类 号：R195.4[医药卫生—卫生统计学]