应用倾向性评分加权法估计2012-2014年福建省疾病监测系统死亡病例漏报率

Estimation of underreporting rate of death cases in disease surveillance system of Fujian province using propensity score weighting method, 2012-2014

目的 了解福建省疾病监测系统死亡病例的漏报情况及其影响因素。方法 采用分层整群随机抽样方法，在福建省20个疾病监测点开展2012-2014年死亡病例的漏报调查。采用logistic回归方法对漏报率的影响因素进行分析，应用倾向性评分加权法对不同年份、城乡、性别、年龄别、死因别的漏报率进行计算。结果 经倾向性评分加权调整后，2012-2014年福建省总漏报率为9.21%（95%CI：9.06%-9.39%），农村的漏报率（11.55%，95%CI：11.30%-11.81%）高于城市漏报率（6.64%，95%CI：6.50%-6.78%）。0-14岁人群死亡的漏报率最高（36.29%，95%CI：34.23%-38.67%），≥65岁人群最低（7.91%，95%CI：7.78%-8.03%）。围生期疾病、先天性异常和损伤中毒的漏报率较高。结论 福建省城乡、年龄别和死因别的漏报率不同，倾向性评分加权法可以用于调整福建省人群死亡病例的漏报率。

Objective To understand the underreporting of death cases and related factors in disease surveillance system of Fujian province. Methods We carried out a field underreporting survey in 20 disease surveillance sites selected through stratified cluster random sampling during 2012-2014. The related factors of underreporting were analyzed by using logistic regression method. Propensity score weighting method was used to calculate the underreporting rate in different groups classified by year, urban/rural areas, gender, age and death cause variables. Results The overall underreporting rate was 9.21%（95%CI： 9.06%-9.39%） after adjusting by propensity score weighting method. The underreporting rate was higher in rural area （11.55%, 95%CI： 11.30%-11.81%） than in urban area （6.64%, 95%CI： 6.50%-6.78%）. The underreporting rate was highest in age group 0-14 years （36.29%, 95%CI： 34.23%-38.67%） and lowest in age group ≥65 years （7.91%, 95%CI：7.78%-8.03%）. The underreporting rate was higher in people died of perinatal disease, congenital anomalies and injury. Conclusion The underreporting rates were different between different groups classified by urban/rural areas, age and death cause variables. Propensity score weighting method can be used to adjust underreporting rate of death cases in mortality surveillance in Fujian.