基于多来源数据的上海市宝山区重点慢性病健康管理数据的质量分析

Quality analysis of multi-source data for health management in major chronic diseases in Baoshan District of Shanghai

【目的】基于信息化多平台大数据分析,了解2017年以来上海市宝山区高血压、糖尿病患者健康管理数据的质量变化情况,进一步评估质控措施的效果,为开展慢性病防治和管理提供建议。【方法】抽取2017和2019年宝山区高血压、糖尿病在管患者不同数据来源的身高、体重、血糖及诊疗信息等数据,分析不同来源数据的一致性等情况。【结果】2019年同时患有高血压和糖尿病患者(简称“高血压糖尿病共患者”)体重不一致比例低于2017年(10.99%与18.72%,χ^2=822.38,P<0.001),2019年身高不一致比例低于2017年(0.86%与2.74%,χ^2=347.03,P<0.001),差异均具有统计学意义;2019年高血压建卡对象诊疗溯源异常比例高于2017年(12.67%与11.72%,χ^2=4.01,P=0.045),差异具有统计学意义,在糖尿病建卡对象中也得到相似的结果;2019年我区糖尿病患者糖化血红蛋白值各末尾构成比的变异系数明显低于2017年(0.19与0.31),且2019年糖化血红蛋白值末尾值为0的比例(4701例,12.72%)低于2017年(9485例,17.14%),差异具有统计学意义。【结论】上海市宝山区高血压、糖尿病健康管理数据质量有一定提升,应综合运用信息化手段,推进技术标准化,继续加强技术培训、数据质量控制和效果评价。

[Objective]An analysis of informationized multi-platform big data was conducted to learn about the quality change of health management data for hypertension and diabetes patients in Baoshan District of Shanghai since 2017.The result provided important information for further evaluation of the effect of quality control measures,and the prevention and management of chronic diseases.[Methods]Height,weight,blood glucose level,diagnosis and treatment information were collected from different databases of patients with hypertension and diabetes in Baoshan District from 2017 to 2019,and the consistency of the data from different sources was analyzed.[Results]Both the percentages of weight and height inconsistency among patients with hypertension and diabetes together were lower in 2019 than in 2017(10.99%vs 18.72%,χ^2=822.38,P<0.001 and 0.86%vs 2.74%,χ^2=347.03,P<0.001,respectively).In 2019,the percentage of registered hypertensive patients with abnormal traceability from diagnosis was higher than that in 2017(12.67%vs 11.72%,χ^2=4.01,P=0.045).Similar results were also obtained in patients with diabetes.Analysis of glycated hemoglobin value last position in diabetic patients showed that the coefficient of variation of the last position composition ratio of the value in 2019 was significantly lower than that in 2017(0.19 vs 0.31).The ratio in patients with the last position of glycosylated hemoglobin value of 0 was lower in 2019(4701 cases,12.72%)than that in 2017(9485 cases,17.14%),and the difference was statistically significant.[Conclusion]The study result shows an improvement in quality management of hypertension and diabetes in Baoshan District of Shanghai.Information technology should be more widely used in promoting technical standardization,strengthening technical training,data quality control and effect evaluation.