湖南省医疗机构梅毒报告质量评价
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摘要
目的评价湖南省医疗机构梅毒报告质量。方法从国家传染病报告管理信息系统收集2010年和2017年湖南省126家二级乙等以上医疗机构报告的梅毒病例资料,依据WS 273—2018 《梅毒诊断标准》和《性传播疾病临床诊疗与防治指南》核查梅毒病例网络报告原始信息、门诊或住院记录和实验室检测记录等,按不同年份、医疗机构级别、类型、科室评价梅毒报告诊断正确率和梅毒报告分期正确率。结果湖南省126家医疗机构2010年报告梅毒8 947例,2017年报告梅毒13 552例,2017年梅毒诊断正确率和分期正确率分别为98.81%和98.66%,高于2010年的36.39%和36.10%(P<0.01)。省、市、县级医疗机构2017年梅毒诊断正确率分别为99.07%、99.20%和98.17%,分期正确率分别为98.91%、99.03%和97.99%,不同级别医疗机构梅毒诊断正确率和分期正确率差异均有统计学意义(P<0.01)。综合性医院、中医院、妇幼保健院2017年梅毒诊断正确率分别为99.25%、96.92%和97.57%,分期正确率分别为99.13%、96.72%和97.30%,不同类型医疗机构梅毒诊断正确率和分期正确率差异均有统计学意义(P<0.01)。皮肤科和非皮肤科2017年梅毒诊断正确率分别为99.13%和98.74%,分期正确率分别为99.02%和98.58%,皮肤科和非皮肤科梅毒诊断正确率和分期正确率差异均无统计学意义(P>0.05)。结论湖南省医疗机构梅毒诊断正确率和分期正确率2017年较2010年明显提高,但医疗机构不同级别、类型之间仍存在差距。
Objective To assess the quality of syphilis case reporting from hospitals in Hunan Province. Methods The syphilis cases reported by 126 middle second-class and above hospitals in the year 2010 and 2017 were retrieved from unified infectious case reporting network and compared with original reporting cards,medical records and laboratory testing records according to the Diagnostic Criteria for Syphilis (WS 273-2018) and the Guidelines for the Clinical Diagnosis and Treatment of Sexually Transmitted Diseases. The accuracy of syphilis diagnosis and classification were evaluated between different reporting years,types of hospitals,levels of hospitals and departments. Results There were 8 947 syphilis cases reported in 2010 and 13 552 syphilis cases reported in 2017. The accuracy of syphilis diagnosis and classification were 98.81% and 98.66% in 2017, which were higher than 36.39% and 36.10% in 2010 (P <0.01). The accuracy of syphilis diagnosis in the provincial, municipal and county-level hospitals in 2017 were 99.07%,99.20% and 98.17%;the accuracy of syphilis classification were 98.91%,99.03%and 97.99%;the accuracy of syphilis diagnosis and classification were significantly different in different levels of hospitals (P<0.01). The accuracy of syphilis diagnosis in the general hospitals,traditional Chinese medicine hospitals and maternal & child health hospitals in 2017 were 99.25%,96.92% and 97.57%;the accuracy of syphilis classification were 99.13%,96.72% and97.30%; the accuracy of syphilis diagnosis and classification were significantly different in different types of hospitals (P <0.01). The accuracy of syphilis diagnosis in the department of dermatology and non-dermatology in 2017 were 99.13% and98.74%;the accuracy of syphilis classification were 99.02% and 98.58%;the accuracy of syphilis diagnosis and classification were not significantly different in different departments (P >0.05). Conclusion The accuracy of syphilis diagnosis and classification have been improved in 2017,which varies in different levels and types of hospitals.
Objective To assess the quality of syphilis case reporting from hospitals in Hunan Province. Methods The syphilis cases reported by 126 middle second-class and above hospitals in the year 2010 and 2017 were retrieved from unified infectious case reporting network and compared with original reporting cards,medical records and laboratory testing records according to the Diagnostic Criteria for Syphilis (WS 273-2018) and the Guidelines for the Clinical Diagnosis and Treatment of Sexually Transmitted Diseases. The accuracy of syphilis diagnosis and classification were evaluated between different reporting years,types of hospitals,levels of hospitals and departments. Results There were 8 947 syphilis cases reported in 2010 and 13 552 syphilis cases reported in 2017. The accuracy of syphilis diagnosis and classification were 98.81% and 98.66% in 2017, which were higher than 36.39% and 36.10% in 2010 (P <0.01). The accuracy of syphilis diagnosis in the provincial, municipal and county-level hospitals in 2017 were 99.07%,99.20% and 98.17%;the accuracy of syphilis classification were 98.91%,99.03%and 97.99%;the accuracy of syphilis diagnosis and classification were significantly different in different levels of hospitals (P<0.01). The accuracy of syphilis diagnosis in the general hospitals,traditional Chinese medicine hospitals and maternal & child health hospitals in 2017 were 99.25%,96.92% and 97.57%;the accuracy of syphilis classification were 99.13%,96.72% and97.30%; the accuracy of syphilis diagnosis and classification were significantly different in different types of hospitals (P <0.01). The accuracy of syphilis diagnosis in the department of dermatology and non-dermatology in 2017 were 99.13% and98.74%;the accuracy of syphilis classification were 99.02% and 98.58%;the accuracy of syphilis diagnosis and classification were not significantly different in different departments (P >0.05). Conclusion The accuracy of syphilis diagnosis and classification have been improved in 2017,which varies in different levels and types of hospitals.
引文
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[13]胡洋,宇翔,张欢,等.2013-2015年江西省女性婚检人群及孕产妇艾滋病、梅毒和乙肝检测状况分析[J].现代预防医学,2017,44(1):170-173.
[14]沈鸿程,赵培祯,苏桂华,等.广东省珠三角地区促进性病门诊就诊者HIV及梅毒检测干预研究[J].现代预防医学,2018,45(13):2456-2459.
[15]陈详生.我国梅毒流行现状及防治策略[J].国际流行病学传染病杂志,2008,35(2):73-77.
[16]杨利群,钱一建,赵峥,等.桐乡市梅毒防治成效分析[J].预防医学,2016,28(8):863-864.
[17]马宁,阎涵,王莉.辽宁省实施《中国预防与控制梅毒规划(2010-2020年)》中期评估结果[J].预防医学,2018,30(7):653-657.
[18]中华人民共和国国家卫生和计划生育委员会.性病防治管理办法[EB/OL].(2012-11-23)[2018-07-18].http://www.moh.gov.cn/mohzcfgs/s3576/201212/cba30083e498409f913515da 47cecee7.shtml.
[2]乔瑞,杨玉荣,武立昕,等.包头市2016-2017年梅毒流行状况[J].中国热带医学,2018,18(10):1021-1024.
[3]史临爱,王一溪,杜中强.山西省某市2005-2014年梅毒流行病学调查研究[J].中国预防医学杂志,2016,17(2):157-158.
[4]张琬悦,罗红兵,方清艳,等.2012-2016年云南省梅毒疫情分析[J].中国艾滋病性病,2018,24(9):923-925.
[5]张万宏,徐业华,石卫东,等.2010-2015年武汉市梅毒网络报告发病率与人群估计感染率对比分析[J].实用预防医学,2018,25(10):1184-1186.
[6]单杏仁,杨作凯,卢巧玲.绍兴市性传播疾病流行特征分析[J].预防医学,2017,29(11):1147-1150.
[7]岳晓丽,龚向东,蒋宁,等.中国5省医疗机构梅毒报告病例数据核查质量调查结查分析[J].中国艾滋病性病,2015,21(4):314-317.
[8]姜宪尘,方春福,来时明.衢州市近十年甲乙类传染病疫情分析[J].预防医学,2015,27(3):291-293
[9]王希江,曾光.网络直报后医疗机构报告法定传染病影响因素的调查[J].疾病监测,2006,21(10):551-554.
[10]中华人民共和国国家卫生健康委员会.梅毒诊断标准:WS 273-2018[S].2018.
[11]王千秋,刘全忠,徐金华.性传播疾病临床诊疗与防治指南[M].上海:上海科技出版社,2014:72-89.
[12]中华人民共和国卫生部.关于印发《中国预防与控制梅毒规划(2010-2020年)》的通知[EB/OL].(2010-06-03)[2018-07-18].http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohjbyfkzj/s3585/201006/47778.htm.
[13]胡洋,宇翔,张欢,等.2013-2015年江西省女性婚检人群及孕产妇艾滋病、梅毒和乙肝检测状况分析[J].现代预防医学,2017,44(1):170-173.
[14]沈鸿程,赵培祯,苏桂华,等.广东省珠三角地区促进性病门诊就诊者HIV及梅毒检测干预研究[J].现代预防医学,2018,45(13):2456-2459.
[15]陈详生.我国梅毒流行现状及防治策略[J].国际流行病学传染病杂志,2008,35(2):73-77.
[16]杨利群,钱一建,赵峥,等.桐乡市梅毒防治成效分析[J].预防医学,2016,28(8):863-864.
[17]马宁,阎涵,王莉.辽宁省实施《中国预防与控制梅毒规划(2010-2020年)》中期评估结果[J].预防医学,2018,30(7):653-657.
[18]中华人民共和国国家卫生和计划生育委员会.性病防治管理办法[EB/OL].(2012-11-23)[2018-07-18].http://www.moh.gov.cn/mohzcfgs/s3576/201212/cba30083e498409f913515da 47cecee7.shtml.