北京某区医院的突发事件监测情况调查

Investigation of emergent public health events surveillance in a district hospitals in Beijing

目的 :了解医院突发事件监测机构的设置及相关监测内容 ,为寻找合理的监测指标、完善医院日常监测、建立突发事件监测系统提供科学依据。 方法 :选取北京某区医院为研究现场 ,对该区所有二级和三级医院 (共计 1 5所 )进行问卷调查 ,并回顾门 /急诊量的变化及药品销售量情况。 结果 :5 3.3%的医院现行监测机构设在门 /急诊 ,其余设在其他部门。三级医院监测资料分析周期为每周 ,二级医院为每月。1 5所医院不同程度地对就诊人员的性别、年龄、职业等 1 1项内容实施监测。2 0 0 2年和 2 0 0 3年的 1～ 6月门 /急诊量变化趋势以 3月份为分界点 ,3月份之前基本一致 ;2 0 0 3年 3月份后的门 /急诊量开始与 2 0 0 2年的曲线分离。 SARS流行期间对比往年同期水平销售量增幅最大的药品依次为抗病毒类药、抗生素类药、中药、免疫制剂。结论 :门急诊是医院的重点监测部门 ,监测项目中的人群特征不可忽视。医院门 /急诊量及药品销售变化对突发事件具有警示作用 。

Objective:To investigate the emergent public health events surveillance system in the hospitals, providing references for establishing the disease surveillance system. Methods: Questionnaires were answered by 15 hospitals of 2nd or 3rd grade in a district in Beijing. Fluctuation of the outpatient/emergency cases and the medication sales were also surveyed. Results: Eight hospitals have surveillance system at departments of outpatient and emergency after SARS outbreak. Surveillance data were assessed weekly in the hospitals of 3rd grade and monthly in those of 2nd grade; eleven parameters of patients like gender, age and occupation,etc. were monitored and statistically analyzed. The fluctuation curves of 2002 and that before March 2003 matched to each other, but segregated after March 2003. During SARS outbreak in Beijing, top medication sales were anti virus agent, antibiotic, Chinese traditional medicine, and immunity regulatory agent compared with those of the corresponding period in 2002. Conclusion: Information about the patients seeking medicare at the department of outpatient and emergency is critical for public health surveillance. The case number and the medication sales at the departments of outpatient and emergency might be sensitive parameters for the early detection of the emergent public health event.