陕西省渭南市网络报告梅毒病例质量及影响因素分析

The Accurate Analysis of Reported Syphilis in Weinan City in Shaanxi Province

目的分析陕西省渭南市网络报告梅毒病例质量及其影响因素,为改进梅毒病例报告提供依据。方法对2014年7月1日-2015年6月30日渭南市医疗机构网络报告梅毒病例,与医院管理信息系统或门诊日志登记的病例和实验室检测结果进行核对,计算诊断符合率、报告准确率及漏报率;用Logistic回归模型分析梅毒报告准确率的影响因素。结果共核查39家医疗机构765例梅毒病例,诊断符合率为22.48%,报告准确率为23.53%,漏报率为31.03%。Logistic回归分析结果显示,报告梅毒病例医疗机构具备实验室检测能力、医院开设皮肤性病科、梅毒病例报告科室为皮肤性病科、报告医院为三级/二级医院、梅毒诊断及报告知识知晓情况,影响梅毒报告质量。结论陕西省渭南市梅毒疫情报告质量亟待提高。提高辖区内所有报告梅毒病例医疗机构实验室检测能力,对辖区内医疗机构相关医务人员进行梅毒检验方法、梅毒诊断标准、传染病网络报卡管理培训,有助于提高梅毒报告质量。

Objective To analyze the quality and influence factors of syphilis cases from network in Weinan city of Shaanxi province to provide the support for next control strategy. Methods Calculate accuracy and false negative rate were evaluated syphilis cases （2014-07-01 to 2015-06-30） from medical institutions network in Weinan city by comparing laboratory test results and patients registration. Meanwhile, the influence factors of syphilis cases in Weinan medical institutions were analyzed. Results Among of totally 765 syphilis cases in 39 medical institutions in Weinan city, the accurate diagnostic rate was 22.48% , accurate report rate was 23.53% and missing report rate was 31.03%. The analysis results were that medical institutions which re- ported syphilis cases had the laboratory test ability and Dept. dermatology and venereal disease which repor- ted syphilis cases in hospitals （second-degree and third-degree hospitals） could influence the quality of syphilis report. Conclusion The misdiagnosing, misinformation and misreporting is serious in Weinan syph- ilis cases report system. It need to improve the quality of report, laboratory test in the area. It need to train inspection personnel in medical institutions, clinicians, epidemic reporters in inspect methods, diagnostic cri- teria and the infectious disease network card. The training is meaningful to improve the syphilis report.