2018年-2019年北京市死因登记数据准确性评价分析  

Evaluation Analysis on the Accuracy of Death Cause Registration Data in Beijing from 2018 to 2019

作　　者：王晶[1] Wang Jing(Beijing Center for Disease Prevention and Control,Beijing 100013,China)

机构地区：[1]北京市疾病预防控制中心,北京市100013

出　　处：《中国病案》2024年第8期49-53,共5页Chinese Medical Record

基　　金：北京市疾病预防控制中心科研培育专项(2020-BJYJ-17)。

摘　　要：目的通过对北京市医疗机构院内死亡病例资料进行分析,评估死因登记资料的准确性,以发现存在的问题,提高报告质量。方法针对2018年7月1日-2019年12月31日发生在医院内的4654例死亡病例,专家通过查阅病案资料完成死因链的填写及根本死因的确定及编码,以此为金标准与原死亡证比较来判断原死亡证填报的准确性,并以Kappa值进行评价。结果常规报告根本死因判断准确性为82.08%,其Kappa值为0.815(p<0.05);常规登记报告低报了损伤和中毒(-13.81%)、泌尿生殖系统疾病(-17.50%)、肌肉骨骼和结缔组织疾病(-28.13%);高报了呼吸系统疾病(15.03%)、精神和行为障碍(17.65%)、起源于围生期的情况(20.00%)和寄生虫疾病(66.67%);疾病细分类后,从常规报告与专家诊断错报情况来看,前列腺癌、肺炎、机动车辆交通事故和意外跌落,错报比例均远大于10%。其中常规报告低报最多的是前列腺癌(33.33%),高报最多的是肺炎(43.59%)。结论北京市死因填报准确性很高,死因登记资料准确可靠。本次研究中发现的死亡证填报问题,可以在今后培训中有针对性的改进。Objectives To evaluate the accuracy of death cause registration data by analyzing the data of in-hospital deaths in medical institutions in Beijing,so as to find existing problems and improve the quality of reports.Methods For the 4654 deaths that occurred in hospitals between July 1st,2018 and December 31,2019,experts review medical records,complete the cause of death chain,and code the root cause of death.With this as the gold standard,comparing with the original death certificate to judge the accuracy of the original death certificate,and evaluated it with Kappa value.Results The accuracy of the root cause of death in routine reports was 82.08%,and Kappa value was 0.815(p<0.05);The conventional registration reports underestimated injuries and poisoning(-13.81%),genitourinary diseases(-17.50%),musculoskeletal and connective tissue diseases(-28.13%);respiratory diseases(15.03%),mental and behavioral disorders(17.65%),perinatal conditions(20.00%)and parasitic diseases(66.67%)were highly reported.After detailed classification of diseases,error reporting proportion of prostate cancer,pneumonia,motor vehicle traffic accidents,and accidental falls was far greater than 10%.Among them,prostate cancer(33.33%)was the most underreported in routine reports,while pneumonia(43.59%)was the most highly reported.Conclusions The accuracy of death cause reporting in Beijing was very high,and the death cause registration data were accurate and reliable.The problems found in this study could be improved in the future training.

关 键 词：死因登记 准确性 评价研究 

分 类 号：R195[医药卫生—卫生统计学]