2018—2020年甘肃省白银市肿瘤发病漏报专题调查研究

Investigation on Underreporting Incident Cases of Cancer Registration in Baiyin City of Gansu Province from 2018 to2020

[目的]分析白银市2018—2020年肿瘤登记平台与医疗机构发病漏报情况。[方法]应用捕获-再捕获(CRM)方法开展白银市2018—2020年肿瘤登记发病漏报调查,计算全市恶性肿瘤总体发病率、总体漏报率。调查白银市综合医疗机构肿瘤漏报情况,计算医疗机构漏报率。对医疗机构肿瘤登记报告相关负责人员进行面对面访谈,分析漏报原因。[结果] CRM法估计白银市2018—2020年肿瘤发病11 249例,矫正发病率为216.14/10万,漏报率为14.51%;医疗机构总体漏报率为16.48%,市、县级医院漏报率差异有统计学意义(P<0.05)。面对面访谈调查发现,市级A医院在HIS系统中对肿瘤报告对象进行了强制上报控制,漏报个案均为中枢神经系统良性肿瘤,其他5家医疗机构则主要以白银市常见恶性肿瘤为主;市级C医院有漏报自查制度,但只将住院患者纳入自查,未对门诊患者进行自查,仍存在漏报。[结论]为了获得可靠、完整的肿瘤登记数据,可通过收集医保部门数据进行补充;医疗机构设置HIS系统自动拦截报告功能、定期组织对住院和门诊患者进行自查以减少漏报,对提高报告数据质量具有实际意义。

[Purpose] To analyze the underreporting situation of cancer registration platform and medical institutions in Baiyin City from 2018 to 2020. [Methods] The capture-recapture method(CRM) was applied to carry out the investigation of missed reporting of cancer registration in Baiyin City from 2018 to 2020, and the overall incidence and overall underreporting rate of cancers in the whole city were calculated. The underreporting situation of medical institutions in Baiyin City was investigated, and the underreporting rate of medical institutions was calculated.Face-to-face interviews with responsible personnel of medical institutions were carried out to analyze the reasons for underreporting. [Results] The CRM estimated 11 249 cases in Baiyin City from 2018 to 2020. The adjusted incidence rate was 216.14/105, and the underreporting rate was14.51%. The total underreporting rate of medical institutions was 16.48%, and there were significant differences in underreporting rate between municipal and county level hospitals. The survey with face-to-face interview showed that in municipal hospital A there were compulsory reports of cancer cases in HIS system, and all the underreported cases were benign tumors of the central nervous system;other five medical institutions mainly reported common cancers in Baiyin City;municipal hospital C had a self-examination system of underreporting, but only for inpatients not for outpatients. [Conclusion] In order to obtain reliable and complete cancer registration data, it can be supplemented by collecting data from medical insurance departments. Medical institutions can use the hospital information system(HIS) to automatically intercept reports and organize regular self-examination of inpatients and outpatients to reduce missing reports and improve the quality of report data.