国际疾病分类在法定传染病上报符合率调查中的应用

Application of the International Classification of Diseases in the Investigation of the Reporting Compliance Rate of Infectious Diseases

目的探索国际疾病分类法第十版(ICD-10)用以评价法定传染病上报符合率应用的可行性,为传染病管理提供借鉴。方法以《2020年新疆医管中心DRG绩效分析简报》为依据,选择新疆10所医院2021年1月1日-2022年12月31日的145806例住院患者法定上报传染病住院患者疾病诊断ICD-10编码信息为研究对象,采用帕累托法找出主要传染病病种,应用秩和比和谐系数法评价主要传染病病种的代表性,运用编码校验法对住院病案首页传染病诊断ICD-10代码与传染病上报代码进行校验,分析传染病上报符合率。结果法定上报传染病乙类占64.8%,丙类占35.2%,上报符合率为92.98%。其中三级医院上报符合率(93.61%)高于二级医院(91.73%),二级医院A类符合率(42.86%)高于三级医院(34.48%),三级医院C类符合率(22.87%)高于二级医院(19.31%),差异具有统计学意义(P<0.05)。不符合病例原因中Z码误报占40.78%,分型错误占37.83%,非感染性疾病占21.39%。结论编码校验法有助于提升法定传染病上报符合率判定的精准性,推广与应用前景广阔。

Objectives This study aims to explore the feasibility of applying the International Classification of Diseases(ICD-10)to evaluate the compliance rate of legal infectious disease reporting,so as to provide a reference for infectious disease management.Methods Based on the"2020 Xinjiang Medical Management Center DRG Performance Analysis Briefing",145806 legally reported infectious disease inpatients from 10 hospitals in Xinjiang from January 1,2021 to December 31,2022 were selected as the research subjects.The Pareto method was used to find out the main infectious diseases.rank sum ratio harmony coefficient method was used to evaluate the representativeness of main infectious diseases.The code verification method was used to verify the ICD-10 code of infectious disease diagnosis on the front page of inpatient medical records and the reporting code of infectious diseases.The coincidence rate of reporting infectious diseases was analyzed.Results Class B infectious diseases reported accounted for 64.8%,Class C infectious diseases accounted for 35.2%,and the reporting compliance rate was 92.98%.The compliance rate reported by the tertiary hospitals(93.61%)was higher than that reported by the secondary hospitals(91.73%).The compliance rate of Class A in the secondary hospitals(42.86%)was higher than that reported by the tertiary hospitals(34.48%).The compliance rate of Class C in the tertiary hospitals(22.87%)was higher than that reported by the secondary hospitals(19.31%).The difference was statistically significant(P<0.05).The false alarm of the Z code accounted for 40.78%of the non-conformance reasons.Typing errors accounted for 37.83%,and non-infectious diseases accounted for 21.39%.Conclusions The code verification method helps improve the accuracy of the determination of the compliance rate of legal infectious disease reporting and has broad prospects for promotion and application.