安徽省2019年部分医疗机构丙型病毒性肝炎病例报告质量调查

Investigation on the quality of viral hepatitis C case reporting in some medical institutions in Anhui Province in 2019

目的 了解安徽省医疗机构丙型病毒性肝炎病例报告的质量。方法 抽取丙型病毒性肝炎病例报告数较多的7家不同等级医院,对抽取医院2018年7月1日至2019年6月30日报告的确诊病例、急性病例和丙肝病毒核酸阳性者进行核查,分析病例误报率、漏报率和核酸阳性报告正确率。结果 共核查丙肝确诊病例828例,确诊病例总误报率为46.9%(388/828),其中三级医院确诊病例误报率(46.7%)略低于二级医院(47.6%)(χ^(2)=0.030,P=0.862)。核查丙肝急性病例198例,急性病例总误报率为76.8%(152/198),其中三级医院急性病例误报率(69.2%)明显低于二级医院(96.4%)(χ^(2)=16.397,P<0.001)。检验科检出的1 031例丙肝病毒核酸阳性者中,480例未上报至传染病报告信息管理系统,总漏报率为46.6%,其中三级医院漏报率(49.7%)明显高于二级医院(2.9%)(χ^(2)=57.639,P<0.001);丙肝病毒核酸阳性病例报告正确率为91.7%(505/551),其中三级医院报告正确率(92.5%)明显高于二级医院(85.3%)(χ^(2)=4.098,P=0.043)。结论 安徽省部分医疗机构丙肝病例报告质量不高,应加强医疗机构丙肝诊断标准和报告要求的培训和考核,减少丙肝误报与漏报。

Objective To understand the reporting quality of hepatitis C cases in medical institutions of Anhui Province.Methods Seven hospitals of different levels with a large number of reports of hepatitis C cases were selected.The confirmed cases of hepatitis C,acute cases, and hepatitis C virus nucleic acid positive cases reported by the selected hospitals from July 1,2018 to June 30,2019 were checked.The mistaken report rate, missing report rate and reporting accuracy rate of hepatitis C virus nucleic acid positive cases were calculated.Results A total of 828 confirmed cases of hepatitis C were checked.The overall mistaken report rate of confirmed cases was 46.9%(388/828).The mistaken report rate of confirmed cases in tertiary hospitals(46.7%) was significantly lower than that in secondary hospitals(47.6%)(χ^(2)=0.030,P=0.862).A total of 198 acute cases of hepatitis C were checked, with the overall mistaken report rate of 76.8%(152/198).The mistaken report rate of acute cases in tertiary hospitals(69.2%) was significantly lower than that in secondary hospitals(96.4%)(χ^(2)=16.397,P<0.001).Among 1 031 cases of hepatitis C virus nucleic acid positive that detected from the laboratory, 480 cases were not reported to the infectious disease report information management system.The overall missing report rate of hepatitis C virus nucleic acid positive cases was 46.6%.The missing report rate in tertiary hospitals(49.7%) was significantly higher than that in secondary hospitals(2.9%)(χ^(2)=57.639,P<0.001).The reporting accuracy rate of hepatitis C virus nucleic acid positive cases was 91.7%(505/551),with a significantly higher rate in tertiary hospitals(92.5%) than that in secondary hospitals(85.3%)(χ^(2)=4.098,P=0.043).Conclusion The reporting quality of hepatitis C cases in some medical institutions of Anhui Province is not high.It is necessary to strengthen the training and assessment on diagnosis criteria and reporting of hepatitis C in medical institutions to reduce misreporting and underreporting of hepatitis C.