重庆市肺结核疫情报告管理现状和漏报原因调查分析
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摘要
目的分析医疗机构肺结核报告管理现状和漏报的原因,提出有效减少或避免肺结核漏报的对策。方法 2017年12月至2018年5月采用自制问卷对重庆市各级各类医疗机构94家共326名医务人员进行调查。结果调查对象均具备肺结核疫情报告所需人力和硬件,相关管理制度如自查、奖惩制度基本建立,但肺结核诊断报告相关知识培训的覆盖面不全,临床医生对肺结核报告相关知识的掌握情况不佳,报卡信息化程度低、费时、麻烦。医务人员报告意识不强、医生临床工作太忙无暇顾及和临床医生缺乏肺结核报告相关知识是肺结核漏报的三大可能原因。结论重庆市肺结核疫情报告管理存在较多问题,亟待加强医院信息化建设实现肺结核报告智能化和强化肺结核报告相关知识培训。
Objective To explore the management status quo of pulmonary tuberculosis(TB)report and under-reporting reasons in medical institutions,and to put forward the strategy for effectively reducing or avoiding pulmonary TB under-reporting.Methods The self-made questionnaire was adopted to conduct the investigation on 326 medical staffs in 94 various levels and types of medical institutions in Chongqing City from December 2017 to May 2018.Results The respondents all possessed the required manpower and hardware,the related management systems such as the self-inspection,rewards and penalties systems were established,but the covering area of pulmonary TB report related knowledge training was incomplete,such as low informatization degree,time-consuming and troublesome.The report awareness of medical staffs was not strong,the doctor was too busy in clinical work without spare time and clinical doctors lacked the pulmonary TB report related knowledge,which were the 3 possible causes of pulmonary TB under-reporting.ConclusionMany problems exist in the pulmonary TB epidemic report management in Chongqing City.It is urgent to strengthen the hospital informatization construction to realize the intellectualization of pulmonary TB report and intensify the pulmonary TB report related knowledge training.
Objective To explore the management status quo of pulmonary tuberculosis(TB)report and under-reporting reasons in medical institutions,and to put forward the strategy for effectively reducing or avoiding pulmonary TB under-reporting.Methods The self-made questionnaire was adopted to conduct the investigation on 326 medical staffs in 94 various levels and types of medical institutions in Chongqing City from December 2017 to May 2018.Results The respondents all possessed the required manpower and hardware,the related management systems such as the self-inspection,rewards and penalties systems were established,but the covering area of pulmonary TB report related knowledge training was incomplete,such as low informatization degree,time-consuming and troublesome.The report awareness of medical staffs was not strong,the doctor was too busy in clinical work without spare time and clinical doctors lacked the pulmonary TB report related knowledge,which were the 3 possible causes of pulmonary TB under-reporting.ConclusionMany problems exist in the pulmonary TB epidemic report management in Chongqing City.It is urgent to strengthen the hospital informatization construction to realize the intellectualization of pulmonary TB report and intensify the pulmonary TB report related knowledge training.
引文
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[2]夏愔愔,阮云洲,张慧,等.2010年我国城乡肺结核患者就诊报告过程及其相关因素分析[J].中国防痨杂志,2014,36(5):331-336.
[3]郭青,苏雪梅,王晓风,等.2013年全国医疗机构法定传染病报告率调查分析[J].中华疾病控制杂志,2017,19(7):683-687.
[4]汪维广.传染病漏报原因分析及对策[J].卫生职业教育,2014,32(20):110-112.
[5]World Health Organization.Global tuberculosis report2016[M].Geneva:World Health Organization,2016.
[6]马莉诊,罗湘蜀,杨长虹,等.2015年四川省医疗机构传染病漏报情况调查[J].预防医学情报杂志,2017,33(3):247-251.
[7]孙闪华,高志东,陶荔莹,等.2011-2015年北京市非结核病防治机构肺结核患者报告和转诊质量分析[J].中国防痨杂志,2016,38(12):1041-1046.
[8]庞芬,石向辉,范苏云,等.深圳市福田区2013-2015年医疗机构传染病漏报调查[J].海峡预防医学杂志,2017,23(2):35-37.
[9]胡雅飞,常癑,李未,等.台州市医疗机构法定传染病报告情况[J].预防医学,2016,28(12):1262-1264.
[10]景莉,李莉莉,李莉莉,等.信息化在医院传染病疫情监控管理中的作用[J].当代护士(学术版),2014,7:185-186.
[11]王静,张越巍,王韬,等.信息化建设在医院传染病管理中的作用[J].中华医院感染学杂志,2015,25(21):4996-4998.
[12]刘伯伟,索继江,杜明梅,等.传染病实时监控系统在活动性肺结核管理中的应用[J].中华老年多器官疾病杂志,2016,15(9):645-649.
[13]成瑶,赵平.肺结核实时监管系统在医院传染病信息化管理中的应用研究[J].医疗卫生装备,2016,37(12):64-67.
[14]施小明,马家奇,杨功焕.我国医疗机构传染病疫情报告管理工作中存在的问题及改进对策[J].疾病监测,2006,21(5):225-226.