重庆市部分医疗机构丙型病毒性肝炎病例报告质量评价

摘要

Objective To understand the current situation of hepatitis C case report in Chongqing municipal medical institutions to provide a decision-making basis for improving the quality of hepatitis C case report. Methods The stratified cluster sampling method was adopted to select 9 medical institutions from 5 districts and counties of Chongqing City.The related data quality of hepatitis C case report during the first quarter of 2014 was checked.Results Among 437 cases of anti-hepatitis C virus(HCV)positive and HCV-RNA positive detected by laboratory,102 cases were reported,the report rate in that year was 23.34%.Among the hospitali-zation cases,there were 36 cases of correctly classified diagnosis with the correct rate of 43.90%,30 cases of correctly classified disease course with the correct rate of 36.59%.The report rate in the provincial hospitals were lower than that in the district and county hospitals(X2=112.648,P=0.000),but the correct rate of di-agnosis and disease course classification in the provincial hospitals were higher than those in the district and county hospitals,the differences were statistically significant(X2= 15.143,15.887,P = 0.000). Conclusion T he annual report rate,and correct rates of diagnosis classification and disease course classifica-tion in the medical institutions of this city are lower at the present.It is necessary to strengthen the training of medical staff on hepatitis C diagnostic report standards and strengthen the popular science propaganda of knowledge of hepatitis C prevention and treatment and improve the quality of hepatitis C case report data.%目的 了解重庆市医疗机构丙型病毒性肝炎(简称丙肝)病例报告现状,为提高该市丙肝病例报告质量提供决策依据.方法 采取分层整群抽样方法从重庆市5个县(区)中选取9家医疗机构,对其2014年1季度丙肝病例相关数据质量进行核查.结果 437例实验室检出抗丙型肝炎病毒抗体阳性者和丙型肝炎病毒核糖核酸阳性者中,共报告102例,当年报告率为23.34%.报告的住院病例中,诊断分类正确36例,正确率为43.90%,病程分类正确30例,正确率36.59%.其中省级医院报告率低于区县级医院(X2= 112.648,P=0.000),省级医院诊断分类和病程分类正确率高于区县级医院,差异均有统计学意义(X2=15.143、15.887,P=0.000).结论 目前该市医疗机构病例当年报告率、诊断分类正确率和病程分类正确率均较低,需加强对医护人员丙肝诊断报告标准的培训,加大丙肝防治知识科普宣传,提高丙肝病例报告数据质量.