11家医院丙型病毒性肝炎病例报告质量分析

An analysis of case reporting quality of hepatitis C in 11 hospitals

目的了解医疗机构丙型病毒性肝炎(简称"丙肝")病例报告的质量,发现存在的问题,为进一步规范丙肝病例报告程序和提高病例报告数据的质量提供依据。方法选取两个省的部分市、县级医院,对其2013年第1季度丙肝病例报告情况进行调查和分析。结果共调查了11家医院,2013年第1季度共报告丙肝病例302例,漏报177例,总漏报率37.0%,其中市级医院漏报率为42.1%,县级医院为33.3%,差异有统计学意义(χ2=3.854,P=0.05)。在报告的302例丙肝病例中,不符合丙肝诊断标准的有36例,总误报率为11.9%,其中市级医院误报率为22.8%,县级医院为5.3%,差异有统计学意义(χ2=20.671,P<0.0001)。结论丙肝病例报告质量普遍较差,在丙肝病例报告中存在较严重的漏报和误报问题,应对医务人员加强丙肝诊断报告标准的培训,进一步规范丙肝病例报告程序,提高报告数据质量。

Objective To learn about the case reporting quality of hepatitis C, and provide basis for further improvement on standard of report procedure and quality of hepatitis C case report. Methods Several hospitals at prefectural and county levels were selected. Then the case reports of hepatitis C from January to March 2013 were investigated and analyzed. Results A total of 11 hospitals were investigated, There were 302 cases of hepatitis C reported and 177 cases missed in the first quarter of 2013. The overall missing report rate was 37.0%, and those at prefectural and county levels were 42.1 % and 33.3%, respectively. There were significant differences in missing report rates between different level hospitals （X2 = 3. 854,P= 0.05）. Of 302 reported HCV cases, 36 were misdiagnosed with the mistaken report rate of 11.9%. The mistaken report rates at prefectural and county levels were 22.8% and 5.3%, respectively, with significant differences between the two different levels （2 =20. 671,P〈 0. 0001 ）. Conclusions The case reporting quality of hepatitis C in medical facilities is poor. Both missing report and mistaken report largely exist. The training of standard diagnosis and report of hepatitis C should be conducted in health workers to enhance cases reporting quality. The reporting process should be more standardized in order to improve the quality of report data.