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目的通过调查2012年天津市各级医疗机构法定传染病疫情漏报情况及其报告质量,了解天津市传染病报告模式的可行性,为进一步提高传染病网络直报工作效率和质量提供理论依据。方法随机抽取全市16个区县54所医疗机构进行现场评估。结果共查出传染病17种1 698例,漏报58例,总漏报率为3.42%;医疗机构门诊日志/出院登记传染病漏报率为2.34%;化验室传染病漏报率为5.74%;调查的乙类、丙类和其他传染病漏报率分别为3.35%、3.27%和5.00%,差异无统计学意义(χ2=1.02,P>0.05);总漏报率最高的为二级医疗机构(4.88%);不同级别医院总漏报率差异有统计学意义(χ2=15.24,P<0.01),总漏报率最高的为郊县(8.18%),其次为滨海新区(4.35%)和环城四区(1.53%),市区漏报率最低(0.90%),各地区之间差异有统计学意义(χ2=46.47,P<0.01)。结论天津市目前的传染病报告管理模式,适合该市传染病报告的需要,应继续加强医疗机构传染病报告管理意识,加强郊县医疗机构的培训和督导。
OBJECTIVE: To investigate the situation of the omission of notifiable infectious diseases in Tianjin medical institutions at all levels and the quality of its reports in 2012 so as to understand the feasibility of reporting modes of infectious diseases in Tianjin and provide a theoretical basis for further improving the efficiency and quality of direct reporting of infectious diseases. Methods A total of 54 medical institutions in 16 districts and counties in the city were randomly selected for field assessment. Results A total of 1 698 cases of infectious diseases were found, of which 58 cases were missed. The total false negative rate was 3.42%. The outpatient log / outpatient communicable disease missed 2.34% in medical institutions. The false negative rate of laboratory infectious diseases was 5.74 %. The omission rates of category B, C and other infectious diseases were 3.35%, 3.27% and 5.00% respectively, with no significant difference (χ2 = 1.02, P> 0.05) (4.88%). There was a statistically significant difference in total false negative rate (χ2 = 15.24, P <0.01) between different levels of hospitals. The highest total false negative rate was in suburban counties (8.18%), followed by Binhai New Area %), Four districts around the city (1.53%), and the lowest false negative rate (0.90%) in urban area. There was a significant difference among all the districts (χ2 = 46.47, P <0.01). Conclusion The current Tianjin infectious disease reporting management model suits the needs of the city’s infectious disease reporting. It should continue to strengthen the awareness of infectious disease reporting and management in medical institutions and strengthen the training and supervision of medical institutions in suburban areas.