安徽省2013～2014年全国疾病监测系统死因监测数据质量评价

Quality evaluation of the reporting death cases in national disease surveillance points of Anhui,2013-2014

目的评估安徽省全国疾病监测系统死亡数据质量,为进一步改进数据质量和提高利用提供依据。方法收集安徽省2013~2014年24个全国疾病监测点数据,采用报告及时率、审核及时率、身份证号码填写率、多死因链填写率、粗死亡率、可靠性、根本死因编码准确性等指标评价数据质量。结果 24个国家死因监测点平均报告及时率为76.83%,审核及时率为96.24%,身份证号码填写率为61.85%,多死因链填写率为52.81%,粗死亡率为6.24‰,83.44%死者生前最高诊断单位为县级及以上医疗机构,69.36%死者生前最高诊断依据可靠,常见根本死因编码错误率为3.49%。除审核及时率2014年与2013年差异无统计学意义外,其余所有指标2014年均高于2013年,差异均有统计学意义（P均〈0.001）。多死因链填写率、可靠性依据的比例、根本死因编码正确率农村高于城市外,除报告及时率皖中高于皖南和皖北,报告及时率和身份证号码填写率新增监测点高于老监测点外,其余所有指标2014年均高于2013年,城市高于农村,皖北高于皖南和皖中,老监测点高于新增监测点,差异均有统计学意义（P均〈0.001）。疾病分类上,慢性病的诊断可靠性最高,其次为感染性、母婴及营养缺乏疾病,伤害最低,差异均有统计学意义（P均〈0.001）。结论安徽省全国疾病监测系统死因监测数据质量在不断提高,但总体情况不容乐观。应根据差异特点,将重点性督导、培训与常规督导、培训相结合,完善死因监测工作机制,切实提高数据质量。

Objective To evaluate the quality of death cause reports in national disease surveillance points（ DSP） from2013 to 2014 of Anhui province,and provide basis for improving the data quality and utilization. Methods Data of death cause in 24 DSP of Anhui province. The quality of death cause repots was analyzed and evaluated by the indicators of timely reporting rate,timely auditing rate,complete rate of ID number,complete rate of chain of multiple death causes,crude death rate,reliability,coding accuracy of basic death cause. Results The total timely reporting rate was 76. 83%,timely auditing rate was 96. 24%,complete rate of ID number was 61. 85%,complete rate of chain of multiple death causes was52. 81%,crude death rate was 6. 24‰,83. 44% of the highest diagnostic units were county and above level medical institutions,69. 36% of the highest diagnostic evidence was reliable,and coding error rate of death cause was 3. 49%. Except that there was no significant difference in timely auditing rate between 2014 and 2013,the complete rate of chain of multiple death causes,reliability rate of the highest diagnostic evidence,and coding accuracy rate of basic death cause were all higher in urban areas than that in rural areas,timely reporting rate was higher in central Anhui than that in southern and northern Anhui,timely reporting rate and complete rate of ID number were higher among new added DSP sites than that among old ones,there was significant difference in all the other indicators between 2014 and 2013,and all the other indicators were lower in urban areas than that in rural areas,was higher in northern Anhui than that in central and southern Anhui,was higher among old DSP sites than that among new ones（ P〈0. 001）. The reliability of the diagnosis for chronic non-communicable diseases was the highest,followed by infection,maternal and child,and nutritional deficiency disease,and for injury was the lowest. Conclusion The quality of death cause reports in DSP of Anhui province is rising,but the overall situation is not optimistic. According to these differences,targeted supervision and training should be combined with routine supervision and training, and the mechanism of death surveillance should be perfected,so as to improve the quality of data.