2009-2014年湖北省死因监测地区漏报率变化趋势

Trend of underreporting of death causes in disease surveillance areas,Hubei,2009-2014

目的 了解湖北省死因监测地区漏报率变化趋势,为减少漏报、提高死因监测数据质量提供科学依据。方法2012年根据死因监测地区各乡镇（街道）的平均人口数、平均社会经济水平,从与各监测地区粗死亡率最接近的3个乡镇中选取1个乡镇（街道）。被抽中乡镇（街道）中所有的家庭均作为调查家庭;2015年按照相同的原则,各监测地区随机抽取3个乡镇（街道）,每个抽中的乡镇（街道）再随机抽取3个行政村（居委会）,抽中村（居委会）的所有家庭均为调查家庭;分别调查2009-2011年和2012-2014年湖北省死因监测地区漏报率情况。结果 2012-2014年湖北省死因监测地区死因漏报率较2009-2011年下降,并呈现年度下降趋势,差异均有统计学意义（χ~2=38.09,P=0.00）。2009-2014年湖北省死因监测地区城乡居民的总体死因漏报率均呈下降趋势（χ~2=37.92,P=0.00）。城市女性、农村男性和女性死因漏报率的下降趋势不明显（χ~2=2.82,P=0.09;χ~2=2.37,P=0.12;χ~2=1.48,P=0.22）。2009-2014年的死因漏报率在5岁以上人群中呈明显的年度下降趋势（χ~2=38.68,P=0.00）;在5岁以下婴幼儿中下降趋势不明显,差异无统计学意义。因伤害死亡死因漏报率高于因疾病死亡者（χ~2=5.61,P=0.02）。结论2009-2014年湖北省死因监测地区的漏报率情况总体呈年度下降趋势。5岁以下婴幼儿和农村地区人群死因漏报现象仍较严重,因伤害死亡的漏报率高于因疾病死亡者,应在实际工作中采取相应措施,减少漏报以提高死因数据完整性。

Objective To understand the trend of underreporting of death causes in disease surveillance areas, Hubei province, from 2009 to 2014. Methods In 2012, according to the average population and social economic level of townships （communities） in disease surveillance areas, 1 township （community） was selected from 3 townships （communities） with similar crude mortality rates in each disease surveillance area, a household survey was conducted in all the families in the township （community） selected. In 2015 ,according to the same standard, 9 villages （neighborhoods） were selected from 3 townships randomly selected in each disease surveillance area, a household survey was conducted in all the families in 9 villages （neighborhoods）. So the underreporting of death causes during 2009 -2011 and during 2012 -2014 were surveyed respectively. Results Compared with the period of 2009 - 2011, the underreporting rate of death causes during 2012 -2014 decreased with year and the annual decrease had statistical differences （X2 = 38. 09, P = 0. 00）. From 2009 to 2014 the underrepotting rates of death causes decreased in both urban area and rural area in Hubei （X2 = 37.92, P = 0. 00）, but the underreporting rate in urban females and the gender specific underreporting rates in rural area had no obvious decrease （X2 = 2. 82, P = 0. 09 ; X2 = 2. 37, P = 0. 12; X2 = 1. 48, P = 0. 22）. The underreporting rate of death causes in people aged 〉 5 years decreased with year, the annual decrease had statistical differences （X2 = 38. 68, P = 0. 00）, but the decrease in young children or infants aged 〈 5 years was not obvious. The underreporting rate for injury deaths was higher than that for disease caused deaths （X2 = 5.61, P = 0. 02 ）. Conclusion The overall underreporting rate of death causes decreased with year in Hubei during 2009 - 2014. The underreporting rates in age group 〈 5 years and in rural population were still high. The underreporting rate for injury deaths was higher than that for disease caused deaths. It is necessary to take appropriate measures to reduce the death cause underreporting and improve the completeness of death cause data.