2016-2017年云南省部分法定传染病诊断质量调查分析
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摘要
目的分析评价云南省各级、各类医疗机构部分法定传染病诊断质量水平。方法抽取全省5个州(市)15个县(市/区)共36家医疗机构进行调查,按照现行最新的国家卫生诊断标准进行判定核实。结果调查了13种法定传染病共871例患者,病种诊断符合率为91.60%,病例分类符合率为83.50%,总病例诊断符合率为76.12%;甲型肝炎、乙型肝炎、痢疾、伤寒/副伤寒4种疾病的诊断符合率较低,分别为46.15%、57.93%、59.68%和60.61%;随着医疗机构级别下降,总的病例诊断符合率明显降低,省、州(市)、县(市/区)、乡镇级医疗机构的诊断符合率分别为86.67%、85.84%、73.72%和52.38%。结论云南省法定传染病的诊断符合率较低,基层医疗机构医务人员的传染病诊断和报告水平亟待提高。
Objective To evaluate the diagnosis accordance rates of selected notifiable communicable diseases in Yunnan.Methods The survey was conducted in 36 medical institutions of 15 counties in 5 prefectures in Yunnan according to the latest national standards of diagnosis of communicable diseases. Results A total 871 patients affecting by 13 communicable diseases were surveyed. The disease specific diagnosis accordance rate was 91.60%, the disease classification accordance rate was 83.50% and the overall diagnosis accordance rate was 76.12%. The diagnosis accordance rates of hepatitis A, hepatitis B,bacillary dysentery and typhoid/paratyphoid fever were lower than other diseases, which were 46.15%, 57.93%, 59.68% and 60.61% respectively. As the descending of the level of medical institutions, the diagnosis accordance rate declined. The diagnosis accordance rates in medical institutions at provincial, prefectural, county and township level were 86.67%, 85.84%,73.72% and 52.38% respectively. Conclusion Compared with other provinces, the diagnosis accordance rates of notifiable communicable diseases were low in Yunnan. It is necessary to strengthen the medical staff training on communicable disease diagnosis and reporting in grass root medical institutions in Yunnan.
Objective To evaluate the diagnosis accordance rates of selected notifiable communicable diseases in Yunnan.Methods The survey was conducted in 36 medical institutions of 15 counties in 5 prefectures in Yunnan according to the latest national standards of diagnosis of communicable diseases. Results A total 871 patients affecting by 13 communicable diseases were surveyed. The disease specific diagnosis accordance rate was 91.60%, the disease classification accordance rate was 83.50% and the overall diagnosis accordance rate was 76.12%. The diagnosis accordance rates of hepatitis A, hepatitis B,bacillary dysentery and typhoid/paratyphoid fever were lower than other diseases, which were 46.15%, 57.93%, 59.68% and 60.61% respectively. As the descending of the level of medical institutions, the diagnosis accordance rate declined. The diagnosis accordance rates in medical institutions at provincial, prefectural, county and township level were 86.67%, 85.84%,73.72% and 52.38% respectively. Conclusion Compared with other provinces, the diagnosis accordance rates of notifiable communicable diseases were low in Yunnan. It is necessary to strengthen the medical staff training on communicable disease diagnosis and reporting in grass root medical institutions in Yunnan.
引文
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[6]李媛,吴颖,戴启刚,等.江苏省菌痢和伤寒/副伤寒实验室诊断病例符合率分析[J].现代预防医学,2014, 41(4):727-731.Li Y, Wu Y, Dai QG, et al. Analysis of the consistency of clinical and laboratorial diagnoses for bacillary dysentery and typhoid/paratyphoid in Jiangsu province[J]. Mod Prev Med, 2014,41(4):727-731.
[7]殷凯,蒙进怀,沈潘燕,等.广西壮族自治区柳州市医疗机构梅毒诊断准确率调查[J].疾病监测,2013, 28(9):766-768.Yin K, Meng JH, Shen PY, et al. Survey of accuracy of syphilis diagnosis in medical institutions in Liuzhou[J]. Dis Surveill,2013, 28(9):766-768.
[8]林丹,余向华,潘琼娇,等.温州市2006年与2011年乙型病毒性肝炎诊断符合率比较[J].中国农村卫生事业管理,2013,33(9):1002-1004.Lin D,Yu XH, Pan QJ, et al. Comparison of the diagnosis coincidence rate of viral hepatitis B in Wenzhou between 2006 and2011[J]. Chin Rural Health Ser Administrat, 2013, 33(9):1002-1004.
[2]王凤英,张子根,张玲,等.医院传染病诊断符合率调查分析[J].中华医院感染学杂志,2014, 24(22):5691-5693. DOI:10.11816/cn.ni.2014-133936.Wang FY, Zhang ZG, Zhang L, et al. Investigation and analysis of accordance rate of diagnosis of infectious diseases[J]. Chin J Nosocomiol, 2014, 24(22):5691-5693. DOI:10.11816/cn.ni.2014-133936.
[3]杨存军,高丽,陈爱女,等.象山县法定传染病诊断符合率调查[J].浙江预防医学,2014, 26(4):429-430.Yang CJ, Gao L, Chen AN, et al. Diagnostic accordance rate of notifiable communicable diseases in Xiangshan[J]. Zhejiang JPrev Med,2014, 26(4):429-430.
[4]吕榜军,梁忠福,白玉,等.柳州市2013年部分法定报告传染病诊断准确率调查[J].中国公共卫生管理,2014, 30(5):677-678.Lyu BJ, Liang ZF, Bai Y, et al. Diagnostic accordance rate of notifiable communicable diseases in Liuzhou, 2013[J]. Chin J Public Health Manage, 2014, 30(5):677-678.
[5]袁芳华,郭泽芊,车昆屏,等.2013年黔西南州部分传染病诊断符合率调查分析[J].中国卫生统计,2014, 31(5):871-872.Yuan FH, Guo ZQ, Chen KP, et al. Diagnostic accordance rate of notifiable communicable diseases in Qianxinanzhou, 2013[J]. Chin J Health Statist, 2014, 31(5):871-872.
[6]李媛,吴颖,戴启刚,等.江苏省菌痢和伤寒/副伤寒实验室诊断病例符合率分析[J].现代预防医学,2014, 41(4):727-731.Li Y, Wu Y, Dai QG, et al. Analysis of the consistency of clinical and laboratorial diagnoses for bacillary dysentery and typhoid/paratyphoid in Jiangsu province[J]. Mod Prev Med, 2014,41(4):727-731.
[7]殷凯,蒙进怀,沈潘燕,等.广西壮族自治区柳州市医疗机构梅毒诊断准确率调查[J].疾病监测,2013, 28(9):766-768.Yin K, Meng JH, Shen PY, et al. Survey of accuracy of syphilis diagnosis in medical institutions in Liuzhou[J]. Dis Surveill,2013, 28(9):766-768.
[8]林丹,余向华,潘琼娇,等.温州市2006年与2011年乙型病毒性肝炎诊断符合率比较[J].中国农村卫生事业管理,2013,33(9):1002-1004.Lin D,Yu XH, Pan QJ, et al. Comparison of the diagnosis coincidence rate of viral hepatitis B in Wenzhou between 2006 and2011[J]. Chin Rural Health Ser Administrat, 2013, 33(9):1002-1004.