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目的了解河南省南阳市医疗机构法定传染病漏报情况。方法按照分层随机抽样要求,对市辖13个县(市、区)分别抽取县级及以上综合医院1家,专科医院1家,乡镇卫生院1家以及所辖村卫生所2家共5个单位,查阅2013年度的门诊日志、出入院登记、化验室和放射科登记簿中诊断为法定传染病的病例。其中县级及以上医院随机抽查≥30例、专科医院和乡镇卫生院分别抽查≥12例(病例不足者,全部抽取),村卫生所登记诊断的所有法定传染病,核查传染病漏报情况。结果共调查各级医疗机构66家,其中县级及以上综合医院13家、乡镇卫生院13家、村卫生所26家、专科医院14家。查出应报法定传染病病例755例,实报739例,漏报16例,漏报率为2.12%;其中乙、丙类传染病漏报率分别为1.51%(8/531)和3.57%(8/224),二者差异无统计学意义(χ2=2.319,P=0.128);县、乡、村和专科医疗机构传染病漏报率分别为1.76%(7/397)、1.92%(3/156)、5.56%(1/18)和2.72%(5/184),差异亦无统计学意义(χ2=1.614,P=0.656)。结论南阳市医疗机构法定传染病报告存在漏报现象。
Objective To understand the omission of notifiable infectious diseases in medical institutions in Nanyang City, Henan Province. Methods According to the stratified random sampling requirements, 1 county-level and above general hospitals, 1 specialty hospitals, 1 township hospitals and 2 village clinics under the jurisdiction of the municipality were selected from 13 counties (cities and districts) Units, access to outpatient logs for 2013, entry and exit registrations, cases diagnosed as notifiable infectious diseases in the register of laboratories and radiologists. Among them, more than 30 cases were randomly selected from hospitals at or above the county level. Special hospitals and township hospitals were randomized to check all legal infectious diseases registered by the village clinics for more than 12 cases (all cases were underdeveloped), and to check for missing cases of infectious diseases. Results A total of 66 medical institutions at all levels were surveyed, including 13 general hospitals at county level and above, 13 township hospitals, 26 village clinics and 14 specialized hospitals. 755 cases of reported infectious diseases should be reported, 739 cases were reported as real cases, 16 cases were underreported, and the underreporting rate was 2.12%; among them, the omission rates of cases B and C were 1.51% (8/531) and 3.57% (Χ2 = 2.319, P = 0.128). The rate of undeclared infectious diseases in counties, townships, villages and special medical institutions was 1.76% (7/397) and 1.92% (respectively) 3/156), 5.56% (1/18) and 2.72% (5/184), respectively, with no significant difference (χ2 = 1.614, P = 0.656). Conclusion The report of notifiable infectious diseases in medical institutions in Nanyang City is underreporting.