2015—2017年全国职业病报告和审核时效对比分析

A Comparative Analysis on Timeliness of Occupational Disease Case Reporting and Reviewing in China from 2015 to 2017

目的对比分析2015-2017年职业病诊断机构网络报告时效和职业病报告业务管理机构审核时效,为进一步规范职业病报告质控及提高业务管理提供建议。方法汇总归纳2015-2017年间全国各职业病诊断机构通过"职业病与职业卫生信息监测系统"常规报告的各类职业病(不包括职业性放射性疾病)原始个案资料,使用SPSS23.0软件进行数据统计分析。对于2015-2017年报告时效性和审核时效性比较采用Kruskal-WallisH检验,采用Nemenyi法对不同年度进行比较分析;对于审核状态采用χ^2检验,并采用Bonferroni法矫正检验水准α为0.0167(0.05/3)对不同年度进行比较。结果(1)2015-2017年,3年总报告的及时率为76.17%,按年度分别为72.31%、75.57%和81.01%,呈逐年上升趋势,具有显著统计学差异(P<0.0001)。(2)报告及时率达80%以上的省份数由2015年的10个上升至2017年的20个,有统计学差异(P<0.05)。(3)在次年1月底,3年总的报告终审率为96.57%,由2015年的96.02%提高至2017年的97.24%,有显著统计学差异(P<0.0001)。(4)县级和省级审核用时2015-2017年呈缩短趋势,市级审核用时呈延长趋势,有统计学差异(P<0.05)。结论报告时效性逐年提高;年终审核整体完成情况较好,但各级审核用时仍需进一步缩短。建议国家出台职业病报告管理制度或工作规范,进一步明确报告和审核时限,报告单位完善其报告工作流程,基层机构稳定人员和必要时设置专职工作人员,加强系统的软硬件维护并完善系统稳定性等措施提高报告、审核时效性。

Objective To make a comparative analysis on timeliness of occupational disease case reporting and reviewing in China from 2015 to 2017, and to provide some advice on quality control and management of occupational disease case reporting. Methods The data of occupational disease cases (radioactive occupational disease cases were excluded) was routinely reported by occupational diagnosis institutions from 2015 to 2017, which was collected from "Information System of Occupational Diseases and Occupational Health". A software SPSS 23.0 was used for data processing and analyzing. When comparing the timeliness, Kruskal- Wallis H test was used for comparative analyses;and Nemenyi test was applied for the comparing analyses between every two years if such H test showing statistical difference. When comparing the reviewing status,χ 2 test was used for comparative analysis, and a Bonferroni adjusted α 0.016 7(0.05/3)was applied for the comparing analyses between every two years. Results (1) From 2015 to 2017, the total timely reporting rate was 76.17% and was 72.31%, 75.57% and 81.01%,respectively. Timely reporting rate showed an increasing trend with significant statistical difference( P < 0.000 1).(2)The number of provinces with timely reporting rate above 80% was 10 in 2015, and 20 in 2017,with statistical difference ( P < 0.05).(3)The total final reviewing rate was 96.57% at the end of January of the following year, and the rate was 96.02% in 2015, rising to 97.24% in 2017, with significant statistical difference ( P < 0.000 1).(4)There was an shortening trend of reviewing time consumption at county and provincial level, while a trend of prolongation was showed at city level, which showed statistical difference( P < 0.05). Conclusion The timely reporting rate showed an increasing tendency year by year. The final reviewing was well completed while the reviewing time consumption should be further decreased at each reviewing stage. Some recommendations to improve timeliness of reporting and reviewing are as follows: promulgating regulations and rules with regard to occupational disease case reporting at national level to further clarify the reporting and reviewing time limit;perfecting the reporting procedure in each reporting facility;keeping a stabilized team and setting up professional personnel when necessary;and strengthening the maintenance of the reporting system to keep the stability.