2017年深圳市宝安区医疗机构法定传染病报告质量影响因素分析

Analysis on influencing factors of reporting quality of notifiable communicable diseases in medical institutions,Bao’an district,Shenzhen city,2017

目的了解深圳市宝安区医疗机构法定传染病报告的现况,找到法定传染病报告工作中存在的问题,为提高法定传染病报告综合率找准方向。方法按医疗机构的性质和规模进行分层随机抽样,查看各医疗机构法定传染病报告质量,采取电子问卷对法定传染病报告责任人及网络直报人员进行法定传染病报告知识调查,评估各医疗机构传染病报告质量并运用多因素分析方法寻找其影响因素。结果总共抽查24家医疗机构,有法定传染病报告责任人及网络直报员124人参与电子问卷调查,现场核对法定报告传染病600例,查到有漏报病例15例,漏报率为2.50%,迟报病例16例,迟报率为2.67%,报告卡完整率、准确率和一致率分别为94.83%、88.17%和98.26%,报告质量综合得分为96.34分。不同专业、不同性质医院医务人员法定传染病报告知识的达标率差异有统计学意义(P<0.05)。电子病例系统是否完善(OR=0.45)、法定传染病知识掌握情况(OR=0.39)、奖惩制度的实施(OR=0.70)是影响法定传染病报告质量的主要因素(P<0.01)。结论随着医疗机构传染病电子信息报告系统的不断完善,宝安区法定传染病报卡质量有较大的提升,民办医疗机构与公立医疗机构的报告质量差异较大。

Objective To understand the status of the notifiable communicable diseases reporting quality of medical institutions in Bao’an district,Shenzhen city,and find the root cause that influenced the reporting quality,so as to provide the evidences for improving the overall quality of notifiable communicable diseases reporting.Methods Stratified random sampling was conducted according to the category and scale of medical institutions,the researchers investigated the reporting quality of notifiable communicable diseases in selected medical institutions,and conduct online questionnaires survey to understand the knowledge on notifiable communicable diseases among relevant medical staff.The reporting quality of notifiable communicable diseases was evaluated,and multiple factor analysis was used to analyze the influencing factors.Results A total of 24 medical institutions were investigated,and 94 medical staff and 30 network reporters were questionnaire surveyed.Totally 600 cases of notifiable communicable diseases were reviewed,including 15 missing cases,with the missing rate of 2.50%,and 16 cases were delay reported,with the delay rate of 2.67%.The rate of completion,accuracy and consistency was 94.83%,88.17% and 98.26% respectively.The overall score for reporting quality was 96.34.There was statistically significant difference in the qualified rate of notifiable communicable diseases among medical staff with different majors and worked in medical institutions of different categories(P<0.05).Whether the electronic health record system was perfect(OR=0.45),knowledge on notifiable communicable diseases(OR=0.39),and implementation of rewards and punishment system(OR=0.70)were the main factors that influenced the reporting quality of notifiable communicable diseases(P<0.01).Conclusion With the development of the electronic health record system,there is a large improvement on the reporting quality of notifiable communicable diseases.However,there is a big difference in the reporting quality between private and public medical institutions.