摘要
目的评估广东省医疗机构死因报告质量,为改进质量和提高数据利用提供依据。方法资料来源于"中国疾病控制信息系统——死因登记报告信息系统"广东省2005—2012年网络报告数据,应用描述性流行病学方法,采用县区报告率、单位报告率、报告及时率、审核率、审核及时率、死因编码错误率、医疗机构死亡报告占人群死亡总数比例、县及以上医疗机构死亡报告占医院总死亡比例等指标,对广东省2005—2012年及各地市2012年死因网络报告质量进行评价分析。结果 2005—2012年,广东省死因网络报告数从2005年的35 361例增长到2012年的172 704例,年报告死亡率从38.65/10万逐年上升到164.55/10万(按常住人口测算),县区报告率从88.40%上升到100.00%,县以上医疗机构单位报告率从39.40%上升到69.30%,乡镇卫生院/社区医院的单位报告率从14.24%提升到34.70%;县及以上医疗机构报告及时率从55.25%(2007年)提高到85.19%(2012年),疾控机构的报卡审核率均维持较高水平(94.94%～99.96%),审核及时率从79.90%(2006年)提高到97.56%(2012年),而死因编码错误率从36.62%(2005年)下降到8.59%(2012年)。2012年全省户籍死亡网络报告数占全省户籍死亡总数的比例为27.33%,县及以上医院死亡报告数占医院总死亡数的比例为49.46%。2012年县及以上医疗机构报告率以珠海市(100.00%)、东莞(90.91%)和广州(83.80%)较高,另有6市低于60%;乡镇卫生院/社区医院的单位报告率以江门(89.66%)、广州(78.73%)、深圳(73.17%)较高,另有11个地市低于20%;死因编码错误率以肇庆(2.61%)、珠海(5.04%)、广州(5.14%)较低,另有8个地市高于10%;网络报告死亡数占同期总死亡数的比例以珠海(95.23%)、江门(91.09%)、广州(75.60%)和东莞(65.09%)较高,其余17市均低于40%。结论广东省死因网络报告质量呈现启动初期较低,2008年后逐年明显提升的特点。各地市报告水平发展极不平衡,推行全人群死因监测措施的广州、珠海、江门和东莞报告质量明显优于其余17个地市。推行全人群死因报告策略、持续开展基层技术培训、定期的工作督导和报告质量评价是全面提高报告质量的关键措施。
Objective To evaluate the quality of death cause reports in medical institutions in Guangdong Province and provide the basis for improving the data quality and utilization. Methods Data of death cause in Guangdong Province from 2005 to 2012 were collected from the ＂information system for death cause register and report＂ of ＂China information system for disease control and prevention＂. Using the method of descriptive epidemiology, the quality of death cause repots was analyzed and evaluated by the indicators of county reporting rate, unit reporting rate, timely reporting rate, timely checking rate, coding error rate of death cause, proportion of reporting deaths of medical institutions to deaths among total popula- tion, and proportion of reporting deaths of medical institutions at and above county level to total deaths in these institutes. Results From 2005 to 2012, the reporting death rate of medical institutions in Guangdong were increased from 38. 65/100 000 to 164. 55/100 000, the county reporting rate increased from 88.40% to 100. 00% , the unit reporting rate of medical institutions above county level increased from 39. 40% to 69. 30%, the unit reporting rate of medical institutions at township and community levels in- creased from 14. 24% to 34. 70% , and timely reporting rate increased from 55. 25% in 2007 to 85.19% in 2012. The checking rates were kept higher level （94.94% -99.96% ）. The timely checking rates in- creased from 79.90% in 2006 to 97.56% in 2012 in institutions of disease control and prevention. The coding error rate declined to 8. 59% in 2012 from 36. 62% in 2005. The proportion of reporting deaths of medical institutions to deaths among total population was 27.33% and the proportion of reporting deaths of medical institutions at and above county level to total deaths in these institutes was 49.46%. Among all cit- ies, the top three unit reporting rates of medical institutions were 100. 00% in Zhuhai, 90. 91% in Dong- guan, and 83.80% in Guangzhou, but lower than 60% in six cities; the unit reporting rates at the town medical institutions was ranked by Jiangmen （ 89. 66% ）, Guangzhou （ 78.73% ）, and Shenzhen （73. 17% ）, but lower than 20% in another 11 cities. The proportion of reporting deaths of medical institu- tions to deaths among total population was ranked by Zhuhai （95.23%）, Jiangmen （91.09%）, Guang- zhou （75.60%）, and Dongguan （65.09%） in descending order, but lower than 40% in other cit- ies. Conclusion The quality of death cause reports in medical institutions in Guangdong was improved greatly from 2005 to 2012. But the levels of reporting quality were unbalanced in all cities. The quality of death cause reports were better in Guangzhou, Zhuhai, Jiangmen and Dongguan City than the other 17 cit- ies. It is essential to promote the strategy for death cause reporting of the population, sustain training for grassroots health workers, and evaluate the reporting quality at regular intervals.
出处
《华南预防医学》
2013年第3期22-27,32,共7页
South China Journal of Preventive Medicine
关键词
死亡原因
医疗机构
信息系统
Cause of death
Medical institutions
Information systems
