2004—2012年天津市医疗机构法定传染病漏报情况分析

Underreporting of notifiable communicable diseases in medical institutions in Tianjin,2004-2012

目的掌握天津市2004—2012年法定传染病漏报情况,为规范传染病报告工作提出相应对策。方法采用天津市2004—2012年间按照《全国法定传染病漏报调查方案》开展的医疗机构法定传染病调查数据,分析医疗机构漏报率相关指标,并运用SPSS 11.5软件对相关指标进行分析。结果 2004—2012年,天津市在医疗机构法定传染病漏报调查中,共查出传染病18 153例,漏报1214例,总漏报率为6.69%;漏报率呈下降趋势,差异有统计学意义(χ2=914.73,P=0.000)。丙类传染病漏报率明显高于乙类传染病,差异有统计学意义(χ2=52.54,P=0.000)。根据不同的管理时期,分为2004—2008、2009—2012年两个时段,一、二和三级医疗机构的漏报率在这两个时段中,漏报率均有了明显降低,差异有统计学意义。并且医疗机构级别越高,漏报率下降的越明显(MantelHaenszel:χ2=562.13,P=0.000)。结论加强《传染病防治法》等有关法律法规的培训,加大对各级医疗单位的传染病专项督导检查力度,提高医务人员报告疫情的自觉性,可以有效地降低传染病漏报率,提高传染病报告水平。不同级别的医疗机构,由于近年来管理模式的不同及信息化手段的应用,对传染病报告水平的影响有所不同。

Objective To understand the underreporting of notifiable communicable diseases in Tianjin from 2004 to 2012 and provide evidence for developing measures to standardize communicable disease reporting. Methods The data about communicable disease reporting during this period in Tianjin, which were collected through the stLrveys conducted according the national communicable disease underreporting survey protocol, were used to evaluate the performance of communicable reporting with software SPSS 11.5. Results According to the survey during this period, a total of 18 153 communicable disease cases occurred, but 1214 were not reported, the underreporting rate was 6.69%. The underreporting rate decreased with year, the differences in annual underreporting rate were statistically significant （X2 = 914. 73, P =0. 000）. The underreporting rate of communicable diseases in Class C was significantly higher than that in Class B, the difference was statistically significant （X2 = 52. 54, P = 0. 000）. The management of communicable disease reporting during 2004 - 2008 and during 2009 - 2012 were different, but the underreporting rates in medical institutions at grade I, ]I and lU were all in decline during these two periods, the difference had statistical significance. The higher the grade was, the more the underreporting rate declined （Mantel-Haenszel： X2 = 562. 13, P = 0. 000） ; Conclusion Strengthening the implementation of the ＂Communicable Disease Prevention and Treatment Law＂ and other relevant regulations, improving the supervision for communicable disease reporting can greatly reduce the underreporting of communicable diseases. The quality of communicable disease reporting varied with the medical institutions at different levels due to the different management practice and informatization level.