行动型国家死亡原因分析工具在海南省2020年死因监测质量分析中的应用

Application of analysis of causes of national death for action in quality analysis of cause of death surveillance in Hainan Province in 2020

目的旨在进一步了解2020年海南省常住居民死因监测数据的漏报情况,探索行动型国家死亡原因分析工具(Analysis of Causes of National Deaths for Action,ANACONDA)在死因监测质量分析中的应用。方法数据来源于海南省疾病预防控制中心人口死亡信息监测管理系统,主要为2020年1月1日—2020年12月31日海南省19个市县死因监测点上报的33418例死亡数据。所有数据通过ANACONDA进行统计分析,死因分类采用国际疾病分类第10版(ICD-10)。结果2020年海南省报告死亡个案共33418例,粗死亡率3.6‰,85岁以下男性死亡占比均高于女性,而在85岁及以上死亡占比则相反。死因监测质量分析显示,2020年海南省死亡监测存在漏报情况,死因漏报率为30.1%;三大类死因各年龄组构成与全球疾病负担区域各年龄组构成均存在差异,中高年龄组的死因误报情况较为显著;2020年海南省死亡数据生命统计性能指标整体得分为52.8,死因的报告质量得分为85.5,可使用的具体死因的级别得分为88.4,改善死因数据质量优先行动区域的死亡报告的完整性所占份额最大,其次是死因报告的质量;男性与女性漏报调查后的具体死因构成比存在差异,但其顺位变化不明显。结论2020年海南省死因监测数据的完整性较低,建议优先改善死亡数据报告的完整性,加强死因监测系统的培训力度,同时定期进行死因监测系统评价与监督。

Objective To further investigate the underreporting of mortality surveillance data among permanent residents in Hainan Province in 2020,and to explore the application of Application of the Analysis of National Causes of Death for Action(ANACONDA)in the quality analysis of mortality surveillance.Methods The data were collected from the Death Information Monitoring and Management System of Hainan Center for Disease Control and Prevention,and mainly included 33418 deaths reported from 19 cities and counties in Hainan Province from January 1,2020 to December 31,2020.All the data were analyzed by the application of ANACONDA,and the causes of death were classified by the International Classification of Diseases,10th Revision(ICD-10).Results A total of 33418 deaths were reported in Hainan Province in 2020,with a crude mortality rate of 3.6‰.The proportion of deaths in males under 85 years old was higher than that in females,while the proportion of deaths in 85 years old and above was opposite.The quality analysis of cause of death surveillance showed that there was under-reporting of death surveillance in Hainan Province in 2020,with an under-reporting rate of 30.1%.There were differences in the age composition and GBD regional composition ratio of deaths of the three major categories of diseases,and the misreporting of causes of death in the middle and high age groups was more significant.The Vital Statistics Performance Index(VSPI)score of death data in Hainan Province in 2020 was 52.8,the score of cause of death reporting quality was 85.5,and the score of specific cause of death level that could be used was 88.4.The completeness of death reports in the priority action areas for improving cause of death data quality accounted for the largest share,followed by the quality of cause of death reports.There was a difference in the proportion of specific causes of death between males and females after the survey,but the change in order was not obvious.Conclusions The data integrity of cause-of-death surveillance is low in Hainan Province in 2020.It is suggested to improve the completeness of reporting data,strengthen the training of cause-of-death surveillance system,and regularly evaluate and supervise the system.