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目的全面了解网络直报模式下医疗机构乙型病毒性肝炎病例的报告质量,为进一步提高监测数据的质量提供理论依据。方法采取分层抽样方法在全国范围内抽取363家医疗机构开展调查。结果本次调查共收集乙肝病例13668例。乙肝病例报告率为72.47%。县及以上医疗机构报告率为73.83%,乡镇及社区级医疗机构为63.91%,两者差异具有统计学意义(P<0.0001)。乙肝住院病例报告率为74.56%,门诊病例报告率为71.07%,差异具有统计学意义(P=0.003)。初诊的乙肝病例报告率为76.01%。病原携带者、假阳性病例及无法判定病例报告率为52.14%。2006年1～9月份乙肝重复报告率为0.61%,2005-2006年跨年度重复报告率为1.42%,其中13.59%的重复报告卡片为病例在不同医院就诊而被重复报告产生。结论乙肝病例报告质量不容乐观,漏报、重复报告以及错误报告并存,这是全国乙肝病例常规监测中普遍存在的问题,为此,建议修订全国乙肝病例报告标准,规范乙肝病例报告程序,以进一步提高监测数据的准确性,为乙肝防治工作提供科学依据。
Objective To fully understand the report quality of hepatitis B cases in medical institutions under the network direct reporting mode and provide a theoretical basis for further improving the quality of monitoring data. Methods A stratified sampling method was adopted to survey 363 medical institutions nationwide. Results The survey collected 13,668 cases of hepatitis B cases. The reported rate of hepatitis B cases was 72.47%. The report rate of medical institutions at county level and above was 73.83%, and that of township and community level medical institutions was 63.91%. There was a significant difference between the two (P <0.0001). The reported rate of hepatitis B inpatients was 74.56% and the outpatient cases was 71.07%, the difference was statistically significant (P = 0.003). The reported rate of newly diagnosed hepatitis B cases was 76.01%. Pathogen carriers, false positive cases and can not determine the case reported rate of 52.14%. From January to September 2006, the reported rate of repeat hepatitis B was 0.61%. The recurring inter-annual report rate was 1.42% in 2005-2006. Of them, 13.59% of repeat report cards were repeatedly reported for cases in different hospitals. Conclusion The quality of hepatitis B cases report is not optimistic, omissions, repeated reports and false reports coexist, which is a common problem in the routine monitoring of hepatitis B cases in our country. Therefore, it is suggested that the national hepatitis B case report should be revised to regulate the hepatitis B case reporting procedure Improve the accuracy of monitoring data and provide a scientific basis for prevention and control of hepatitis B.