泸州市传染病零缺报和报告病例较少单位管理现状分析

Management Situation of Institutions Reporting Zero or a Few Communicable Disease Cases in Luzhou

目的了解泸州市传染病"零缺报"和报告病例较少单位的管理现状,为提高泸州市传染病报告管理水平和报告质量提供依据。方法检查报告传染病病例数均少于泸州市县级以上医疗机构平均报告水平的中医医院、妇幼保健院和报告病例较少或"零缺报"的乡镇卫生院29个,参照《2011年四川省医疗机构传染病网络直报质量督导检查方案》和《2010年全国法定传染病网络直报评价调查方案》开展检查和评价。结果 29个单位综合评分为77.52分,其中传染病报告管理、培训、报告质量得分率分别为62.79%、67.59%、90.82%。不同机构综合评分:中医医院85.40分、乡镇卫生院78.75分、妇幼保健院67.03分。门诊日志登记完整率、准确率为5.36%(30/560),使用符合率为86.30%(334/387);出入院记录、检验记录、放射记录登记完整率分别为3.57%(20/560)、66.54%(173/260)、57.95%(113/195)。107名医务人员相关知识平均测试成绩为42.7分,及格率为18.69%;法定传染病报告率为89.58%(129/144),抽查纸质卡246张,报告及时率、完整率、准确率、录入一致率分别为98.37%、94.72%、91.87%、80.08%。结论泸州市传染病零缺报单位和报告病例较少单位的传染病诊断、报告管理水平和报告质量较低,其中妇幼保健院和乡镇卫生院应被列为日常监管的重点单位。院内传染病报告管理和培训部分是薄弱环节。

Objective To understand the status of communicable disease management of medical institutions re- porting zero or a few cases for the purpose of improvement. Methods Twenty - nine hospitals including hospi- tals of Chinese medicine （HCM）, township health centers （THC） and maternal -child health hospitals （MCH） were estimated under communicable disease management instructions, Results The comprehensive score of the 29 institutions was 77.52; scoring rates concerning management, training and reporting quality were 62.79%, 67.59% and 90. 82% respectively. Scores of CTM hospitals, THC and MCH was 85.40, 78.75, and 67.03. Concerning outpatient clinic log, rate of accuracy and usage was 5.36% （ 30/560）, and 86.30% （334/387） respectively. Rates of admission and discharge, inspection records, radiology and records with completeness were 3.57% （20/560）, 66. 54% （173/260） and 57.95% （113/195） respec- tively. The average relevant knowledge score of the 107 medical staff was 42.7 with a pass rate of 18.69%. Reported rate of notifiable diseases was 89.58% （129/144） ; rate of timely report, completeness, accuracy,enter concodance was 98.37%, 94.72% , 91.87% and 80.08% respectively. Conclusion The management quality of communicable disease needs to be improved in MCH and TCH hospitals of Luzhou; reporting management of communicable diseases as well as professional training in hospitals are weaknesses that need to be strengthened.