2018-2020年西安市死因监测漏报调查  

Investigation of underreporting of death monitoring in Xi’an city,2018-2020

作　　者：李文静 毋丹丹[1] 赵国栋[1] 黄春红[1] LI Wenjing;WU Dandan;ZHAO Guodong;HUANG Chunhong(Xi’an Center for Chronic and Non-communicable Disease Control and Prevention,Xi’an 710054;Department of Epidemiology and Biostatistics,School of Public Health of Xi’an Jiaotong University Health Science Center,Xi’an 710061,China)

机构地区：[1]西安市疾病预防控制中心,陕西西安710054 [2]西安交通大学医学部公共卫生学院流行病学与卫生统计系,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2023年第5期830-835,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省重点研发计划项目(No.2022SF-358)。

摘　　要：目的了解西安市死因监测工作中死亡病例的漏报情况及其影响因素。方法采用分层整群随机抽样方法在西安市44个乡镇(街道)共733个行政村/居委会,通过多途径收集抽样地区常住人口2018—2020年的死亡相关信息,与全国死因监测网络直报系统数据比对,对漏报死亡个案进行入户调查及核实,计算漏报率。组间率的比较采用χ^(2)检验,采用Logistic回归对漏报率的影响因素进行分析。结果共查2018—2020年死亡37650例,合计死亡率650.59/10万,漏报人数为2901人。2018—2020年死亡漏报率分别为9.89%、6.95%和6.24%(χ^(2)=133.525,P<0.001),3年平均漏报率为7.71%,44个调查点漏报率在0.90%~42.07%之间。经Logistic回归分析发现城市漏报率低于农村(OR=0.567,95%CI:0.525~0.613),0~5岁(OR=5.494,95%CI:3.732~8.090)、15~44岁(OR=1.541,95%CI:1.284~1.846)死亡人群漏报率高于其他年龄组人群,2018年(OR=1.702,95%CI:1.551~1.869)、2019年(OR=1.148,95%CI:1.038~1.271)死亡人群漏报率高于2020年。漏报2901例的死亡地点以死于家中者所占比例最高(81.39%),死亡原因以心脏病和脑血管病例所占比例较高,分别为36.80%和27.08%。结论西安市死因监测数据的完整性正逐步提高,2018—2020年死因监测地区的漏报率情况总体呈年度下降趋势。农村地区人群和5岁以下婴幼儿死因漏报现象较为严重,需加强死亡信息的报告和管理工作以减少漏报。Objective To evaluate the underreporting of death cases and related factors in disease surveillance system of Xi’an.Methods Multi-stage cluster random sampling was used,and 733 villages(neighborhood committees)were selected from 44 townships or streets in Xi’an.All the death cases of the residents in the sampled areas from 2018 to 2020 were collected through a variety of channels and checked with those registered in the Disease Surveillance System.Then the missing cases were investigated and verified.The underreporting rate was calculated,the Excel software was applied for statistical processing and Chi square analysis,and the related factors of underreporting were analyzed by using Logistic regression method.Results A total of 37650 death cases were investigated from 2018 to 2020;the average mortality was 650.59/105,and 2901 cases were underreported.From 2018 to 2020,the underreporting rate was 9.89%,6.95%,and 6.24%,respectively(χ^(2)=133.525,P<0.001),with the average underreporting rate of 7.71%.The underreporting rate in the 44 sampled areas ranged from 0.90%to 42.07%.Multivariate Logistic regression analysis showed that compared with that in rural areas(9.87%),the underreporting rate was lower in urban areas(5.91%,OR=0.567,95%CI:0.525-0.613),and higher in children under 5 years old(31.20%,OR=5.494,95%CI:3.732-8.090)and people aged 15-44 years old(11.85%,OR=1.541,95%CI:1.284-1.846)compared to people over 65 years old(7.44%),and higher in 2018(9.89%,OR=1.702,95%CI:1.551-1.869)and 2019(6.95%,OR=1.148,95%CI:1.038-1.271)compared to the year 2020(6.24%).There were 2901 cases reported missing,and the proportion of those who died at home was t he highest(81.39%).Underreporting of death more easily occurred in heart diseases(36.80%)and cerebrovascular diseases(27.08%)than others.Conclusion The reporting completeness of disease surveillance system increased in Xi’an.The overall underreporting rate of death causes decreased with year from 2018 to 2020.The underreporting rates in age group under 5 years old and in

关 键 词：死因监测 漏报率 漏报调查 

分 类 号：R195[医药卫生—卫生统计学]