目的 评估安徽省国家疾病监测点2019年死因数据网报质量。方法 参照CRVS医学死亡证明书质量快速评估工具技术指南(第3版),结合安徽省实际情况形成本次评估方案,采用分层整群随机抽样方法评估安徽省国家死因监测点2019年死因网报数据填报准确性。结果 2019年安徽省国家疾病监测点死因网报数据总准确率、身份证号、死因链、根本死因准确率分别为47.03%,98.18%、52.24%和83.54%。总准确率表现为农村点(49.69%)＞城市点(44.38%),县级以下医疗机构(53.96%)＞县级及以上(40.10%),江淮地区(58.44%)＞江南地区(43.75%)＞淮北地区(38.91%)。死因链准确率在新老点、城乡、报告单位级别和片区间均存在统计学差异(P＜0.05);根本死因准确率在新老点和城乡间存在统计学差异(P＜0.05)。死因填报中“死因链不完整”问题较突出,主要是“终末期疾病未报告基础疾病”“损伤中毒外因未报/不明确”两方面。结论 安徽省死亡病例网报数据质量仍待加强,应重点加强城市点、县级以上医疗机构培训工作。
Abstract
Objective To evaluate the report accuracy of cause of death (COD) data in Anhui national disease surveillance points (DSPs) in 2019,and explore comprehensive indicators. Methods Combined with the actual situation of our province,the rapid quality assessment tool of Medical Certificate of Cause of Death (MCCOD)from CRVS was used to reference and develop this evaluation scheme.Using stratified cluster random sampling method,the COD data were evaluated in Anhui DSPs in 2019. Results The total accuracy of the network reporting COD data in Anhui DSPs in 2019 was 47.03%,and the accuracy of identity card number (ID),the death-causes chain,the basic death cause was 98.18%,52.24% and 83.54%,respectively.The accuracy showed that the rural point (49.69%) was better than the urban point (44.38%),the units below county level (53.96%) was better than that at county level and above (40.10%),and that in Jianghuai area(58.44%) was the highest,jiangnan area (43.75%) was in the middle,and Huaibei area (38.91%) was the lowest.There were differences in the accuracy of death-cause chain between new and old points,urban and rural areas,unit in different levels,and different districts (P＜0.05).The statistically different was existed in the accuracy of the basic death-cause between the new and old points,and that between urban and rural areas (P＜0.05).The incomplete reporting of death cause chain is more prominent,especially in the two aspects,such as the end-stage disease without reporting basic disease and injury poisoning without reporting external cause or unclear external cause. Conclusion The quality of COD data in Anhui DSPs needs to be improved.The quality control work should focus on urban areas,hospitals at or above the county level.
关键词
死因监测 /
质量评估 /
疾病监测点 /
抽样研究
Key words
Death cause surveillance /
Quality Assessment /
Disease surveillance points /
Sampling Studies
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Rampatige R,Gamage S,Richards N,et al.Assessing the quality of death certificates:guidance for the rapid tool.CRVS resources and tools.Melbourne.Bloomberg Philanthropies Data for Health Initiative,Civil Registration and Vital Statistics Improvement,The University of Melbourne.2020 Available from: https://crvsgateway.info/file/9587/62.
[2] Hart JD,Sorchik R,Bo KS,et al.Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative[J].BMC Medicine.2020,18:74.
[3] 赵军,朱丽萍,谢昀,等.江西省2014-2016年死因监测常规与抽查质量评价[J].江西医药,2017,52(11):1233-1235.
[4] 童瑾,黄跃龙,陈碧云,等.2007-2014年湖南省人口死亡信息登记管理系统数据质量分析[J].中国卫生统计,2020,37(1):37-39,42.
[5] 姜晓红,夏云婷,赵靓,等.2018年北京市朝阳区网络直报死亡报告质量评价[J].中国慢性病预防与控制,2020,28(5):397-400.
[6] 邢秀雅,贺琴,陈叶纪,等.安徽省2013-2014年全国疾病监测系统死因监测数据质量评价[J].安徽预防医学杂志,2016,22(6):384-390,427.
[7] 鲍慧芬,孟武,朱君君,等.芜湖市2012年县及以上医疗机构死亡病例报告质量评价[J].现代预防医学,2014,41(5):849-851.
[8] 雷智,张燕,常豫红,等.2013-2016年泸州市县及县级以上医疗机构死因监测漏报调查与报告质量评价[J].预防医学情报杂志,2018,34(5):615-618.
[9] 高林,胡国清.湖南省某市2011—2012年73270份死亡医学证明填报质量分析[D].长沙:中南大学,2014.
[10] 陈光敏,祝寒松,何斐,等.福建省2013年医疗机构死亡病例报告质量调查[J].医学理论与实践,2016,29(21):2999-3001.
[11] 贺琴,刘志荣,陈叶纪,等.安徽省国家疾病监测点2013-2017年死因网报数据质量抽审评估[J].安徽预防医学杂志,2019,25(3):31-35.
[12] 世界卫生组织.疾病和有关健康问题的国际统计分类[M].北京协和医院世界卫生组织疾病分类合作中心编译.第十次修订本.北京:人民卫生出版社,2006.7.
[13] 王黎君,董景武,宋桂香,等.人口死因监测工作指导手册[M].北京:中国人口出版社,2017.6.
[14] 贺琴,陈叶纪,戴丹,等.安徽省2013年居民死因分析[J].中华流行病学杂志,2015,36(9):976-982.
[15] Hasanpour-Heidari S,Jafari-Delouei N,Shokoohifar N,et al.Completeness and Accuracy of Death Registry Data in Golestan,Iran[J].Arch Iran Med,2019,22(1):1-6.
[16] Washirasaksiri C,Raksasagulwong P,Chouriyagune C,et al.Accuracy and the factors influencing the accuracy of death certificates completed by first-year general practitioners in Thailand[J].BMC Health Serv Res,2018,18(1):478.
[17] Filippatos G,Andriopoulos P,Panoutsopoulos G,et al.The quality of death certification practice inGreece[J].Hippokratia,2016,20(1):19-25.
[18] Hazard RH,Chowdhury HR,Adair T,et al.The quality of medical death certification of cause of death in hospitals in rural Bangladesh: impact of introducing the International Form of Medical Certificate of Cause of Death[J].BMC Health Serv Res,2017,17(1):688.
[19] Akakpo PK,Awuku YA,Derkyi-Kwarteng L,et al.Review of errors in the issue of medical certificates of cause of death in a tertiary hospital in Ghana[J].Ghana Med J,2017,51(1):30-35.
[20] Walker S,Rampatige R,Wainiqolo I,et al.An accessible method for teaching doctors about death certification[J].Health Inf Manag,2012,41(1):4-10.
[21] Madadin M,Alhumam AS,Bushulaybi NA,et al.Common errors in writing the cause of death certificate in the Middle East[J].J Forensic Leg Med,2019,68:101864.
PDF(922 KB)
