某国家级死因监测点漏报调查及死因监测质量评价

Survey on missing reports in a national monitoring point for causes of death and evaluation on quality of monitoring on causes of death

目的 了解某国家级死因监测点居民死亡漏报情况,评价死因监测信息系统报告的完整性和准确性。方法 某国家级死因监测点居民死亡信息来源于泸县3个抽样点。采用随机整群抽样的方法,在泸县抽取3个镇(抽样点)共42个村/社,分别从派出所、社事办、妇幼、村(居委会)等渠道收集抽样点2018—2020年全部人口死亡信息,与“人口死因监测信息管理系统”死亡报告数据进行比较,计算漏报率。对“人口死因监测信息管理系统”中抽样点居民死亡报告卡进行审核,评估死因诊断的可靠性和编码质量。结果 泸县人群总死亡漏报率为9.38%;2018—2020年,漏报率逐渐下降,分别为18.31%、7.53%、2.16%,年度变化百分比为-11.9%,变化趋势差异有统计学意义(t=-5.175,P<0.001),抽样点死因诊断可靠性和准确性较高,可靠诊断单位占比81.81%,可靠诊断依据占比75.67%,根本死因编码错误率为0.21%。结论 泸县死因监测数据质量较好,但仍需进一步降低漏报率,提高死因监测数据的完整性和诊断的可靠性。

Objective To investigate the underreporting of deaths among residents in a national monitoring point for causes of death, and to evaluate the integrity and accuracy of reports from the information system for monitoring on causes of death. Methods The death information of residents in a national monitoring point for causes of death was collected from three sampling points in Lu County. A total of 42 villages/communities in 3 towns(sampling points) in Lu County were selected by a random cluster sampling method. The death information of all the population in the sampling points from 2018 to 2020 was collected from police stations, social affairs offices, women and children, villages(neighborhood committees) and other channels, compared with the death report data from the information management system for monitoring on causes of death in population, and then calculated the underreporting rate. The death report cards of residents from the sampling points in the information management system for monitoring on causes of death in population were verified, and the reliability and coding quality of diagnosis of causes of death were evaluated. Results The underreporting rate of total deaths in population in Lu County was 9.38%. The underreporting rate gradually decreased by 18.31% in 2018, 7.53% in 2019 and 2.16% in 2020. The annual percent change was-11.9%. There were statistically significant differences in the changing trend(t=-5.175, P<0.001). The reliability and accuracy of diagnosis of causes of death in the sampling points were high, and the reliable diagnosis units and reliable diagnosis basis accounted for 81.81% and 75.67%, respectively. The coding error rate of fundamental causes of death was 0.21%. Conclusion The quality of data about monitoring on causes of death in Lu County is high, but it is still necessary to further reduce the underreporting rate and improve the integrity of data about monitoring on causes of death and the reliability of diagnosis of causes of death.