某机构职业健康检查记录质量的干预效果评价

Evaluation of intervention effects on data quality of occupational health examination records in a institution

目的评价质量干预效果,为加强职业健康检查记录的质量管理提供指导。方法某体检机构于2016年2月~2016年3月针对职业健康检查的质量管理实施专题培训、通报并解读2015年度体检记录中的问题数据、建立检查科目用语和描述模板/范本、落实考核奖惩措施等多项干预,通过比较2015年度(干预前)和2016年度(干预后)体检记录中问题数据的数量变化,对质量干预效果进行评价,采用Poisson分布的u检验和χ~2检验进行统计推断。结果 2015年和2016年受检记录分别为9 693条和10 127条,在处理建议、内外科和皮肤科、心电图、B超等检查项中的描述用语不规范分别有283处和232处,在内科、心电图和B彩超等项目中的内容混入错位分别有112处和18处,血压项中奇异值由12例减至1例,都呈显著减少(u不规范=2.737 7,χ~2错位=84.730,χ2奇异值=8.965,P均<0.01),身份证号缺失和血常规项奇异值等问题数据减少差异无统计学意义。结论该机构实施的质量干预效果明显,干预后的职业健康检查记录质量有所提高,但干预措施需要细化深化与强化落实。

Objective To provide guidance for quality management by evaluating intervention effects on record quality of occupational health examination （CHE）. Methods Kinds of interventions on data quality of OHE records were put into practice in a physical examination institution from February to March in 2016, including offering thematic training, notice and interpretation for the problem data of OHE records in 2015, providing any subject words and description templates, implementing system of rewards and penalties, etc. Evaluations of intervention effect were depended on the quantity changes of problem data sought out of OHE records in 2015 （before intervention） and in 2016 （after intervention）, based on statistic inference with u-test and X^2-test under Poisson distribution. Results There were 9 693 and 10 127 records respectively received in 2015 and 2016. Among them, the total numbers of non-standard descriptions were respectively 283 and 232 in the columns of treatment suggestions, medicine, surgery, dermatology, ECG and CDUS; The total numbers of mismatches between description and inspection subject were 112 and 18 respectively in the columns of Medicine, Dermatology and CDUS; The total numbers of abnormal values were 12 and 1 respectively in the columns of blood pressure. The 3 amounts above of the problem data after interventions were lower than them before interventions, with statistical difference[u（non-stan- dard）=2.737 7, X^2（mismatches）=84.730, X^2（abnormal values）=8.965, all P〈0.01]. The two amounts of ID number lack and abnormal values in the fields of blood routine examination decreased without statistical difference. Conclusion The quality of OHE records improved obviously after interventions in this institution. However, these interventions need to be enhanced and intensified.