2005年江西省安远县县乡医疗机构传染病漏报及报告质量分析与改进策略探讨

An analysis of missing reports on infectious diseases and the quality of reports from the medical facilities at the levels of county and township in Anyuan County of Jiangxi Province in 2005 and the strategies for the betterment

目的了解安远县实现传染病网络直报后的医院传染病报告工作质量,发现存在问题和探讨改进策略。方法根据《江西省医院法定传染病与死亡病例管理及报告质量调查方案》(2005版),对安远县县乡(镇)两级医疗机构的传染病漏报情况及报告质量进行调查和分析。结果实行网络直报后,安远县医院传染病实际报告率和及时性均有明显提高,漏报率仍然很高,报告及时率和报告质量较低。其中,门诊和辅助科室病例漏报率高于住院病例;性病专科医院和性病科的性病漏报率高于其他医院和科室病例;乡镇卫生院漏报率高于县级医院;但传染病报告的不及时率则县级医院明显高于乡镇卫生院。县乡两级医疗机构的报告卡填写和录入质量无明显差异。结论对传染病报告工作还须从政府的政策、医疗机构的内部管理与疫情报告人员的培训、疾控机构的督查指导等方面采取综合措施加以改进。

Objective The present study was designed to gain an insight into the quality of reports on infectious diseases and the existing problems in the work after the implementation of direct network report in Anyuan County in order to improve the strategies. Methods An investigational analysis was performed of the quality of the reports on infectious diseases from the medical facilities at the levels of county and township in Yuanan County Based on ＂The Survey Protocol for the Quality of Case Management and Report of Notifiable Diseases and Deaths from the Them in the Hospitals in Jiangxi Province（2005 Edition） ＂, Results It was shown that the actual report rate of infectious diseases and the timeliness in the reporting in Anyuan County Hospital were dramatically improved after the implementation of direct network report, but the rate of missing reports was still high with a low timeliness rate of reporting and a low quality of reports, Specifically,the rate of missing reports was higher in outpatient department and auxiliary departments than in in-patient department. The rate of missing reports on sexually transmitted diseases （STD） was higher in specialized hospitals for STD and in departments of STD than in other hospitals and departments, The rate of missing reports on infectious diseases was higher in township hospitals than in hospitals at the county level, and the rate of untimely reports was higher in the hospitals at the county level than in the township hospital. There was no significant difference between the medical facilities at the county level and those at the township level in the qualities of filling out and entering report cards. Conclusion Comprehensive measures, involved in government policies, internal management of medical facilities, training of epidemic reporters and supervision and instruction from CDC, should be taken to improve epidemic reporting of infectious diseases.