合肥市病毒性肝炎网络报告数据质量分析

Network reporting quality and its related factors of viral hepatitis in Hefei city

目的了解合肥市病毒性肝炎网络报告数据质量,为校正病毒性肝炎报告发病率提供科学依据。方法抽查不同级别医疗机构住院病例,按照国家相关规范和病毒性肝炎诊断标准,评估病毒性肝炎的诊断及报告数据质量,同时抽取部分临床医生调查病毒性肝炎的诊断和报告标准知晓率。结果 63家被调查单位均能开展肝功能和乙肝两对半检测,开展甲肝、丙肝和戊肝Ig M抗体检测的单位分别占60.3%、60.9%和65.1%,46.0%的开展丙肝RNA检测。临床医生病毒性肝炎诊断和报告标准知晓率为69.9%。调查病毒性肝炎1 319例,报告率96.5%,及时报告率89.1%,重报率4.1%。网络报告病例诊断准确率84.6%,准确报告率56.2%。结论合肥市不同级别医疗机构的病毒性肝炎诊断准确率和准确报告率不高,临床医生病毒性肝炎诊断和报告标准知晓率低,应加强对临床医生的培训,提高病毒性肝炎报告数据质量。

Objective To understand the data quality of ＂viral hepatitis＂ network report in Hefei, so as to provide the scientific basis for correcting the reported incidence rate of the disease. Methods Hospital cases and some clinicians in different levels of medical institutions were investigated, in order to evaluate the data quality of viral hepatitis diagnosis and reporting, and to know the awareness rate of diagnosis and reporting criteria for viral hepatitis among clinicians, according to the national norms and diagnostic criteria for viral hepatitis. Results All 63 institutions investigated could do liver function test and detect five markers of HBV, in which, hepatitis A IgM, hepatitis C IgM and hepatitis E IgM accounted for 60.3%, 60.9% , and 65.1% , respectively. 46% of the medical institutions carried out hepatitis C RNA testing. The awareness rate of the hepatitis diagnostic and reporting standards was 69.9%. Among 1319 cases with viral hepatitis, the rate of reporting was 96.5% , the rate of timely reporting was 89.1%, and the rate of re - reporting was 4.1%. The accuracy rate of net- work diagnosis was 84.6%, and the accurate reporting rate was 56.2%. Conclusions The rate of accurate diagnosis and correct reporting for viral hepatitis were low among different levels of medical institutions in Hefei, and the awareness rate of diagnosis and reporting criteria for viral hepatitis among clinicians were low too. Therefore, the training clinicians should be strengthened, so as to improve the quality of reporting data for viral hepatitis.