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目的应用捕获-再捕获方法(capture-mark-recapture,CMR)评价山东省居民2012-2013年死因登记漏报率水平,为制定卫生策略提供依据。方法采用分层整群随机抽样法,将全省所有县(市、区)按照2012年死因登记系统报告死亡率分成5层,分层按比例随机抽取14个调查县(区),从抽中的14个县(区)中各随机抽取3个乡镇(街道),每个乡镇(街道)随机抽取10个村(居委会)。从当地公安、民政和村(居委会)搜集人口死亡情况,再与死因登记系统已报告的死亡资料进行比对,计算漏报率。结果本次漏报调查共收集到6 929个死亡案例,其中漏报1 556例,CMR法估算死亡案例为7 622例(95%CI:7 593~7 651),2年合计漏报率为23.15%,2年合计漏报率差异有统计学意义(χ2=697.65,P<0.01)。0~4岁组的2年合计漏报率为56.93%。男性合计漏报率为22.31%,女性合计漏报率为24.09%,两者差异无统计学意义(χ2=3.40,P>0.05)。结论山东省死因登记存在明显漏报,且层间漏报水平不一致,低年龄段的漏报率较高,部分地区低年龄段的死因登记工作不够完善,应进一步加强死因监测工作质量,提高报告数据的完整性,同时需要分层调整死亡率,以更加准确客观地评价山东省居民死亡水平。
Objective To evaluate the false negative rate of death among residents in Shandong province from 2012 to 2013 by using capture-mark-recapture (CMR), and to provide evidence for the development of health strategy. Methods The stratified cluster random sampling method was used to divide the reported death rates of all counties (cities and districts) in the province according to the cause of death registry system in 2012 into five layers, and randomly selected 14 surveyed counties (districts) Of the 14 counties (districts) randomly selected three towns (streets), each township (street) randomly selected 10 villages (neighborhood). Collecting population deaths from local public security, civil affairs and villages (neighborhood committees) and comparing them with the death data already reported by the cause of death registration system to calculate the false negative rate. Results A total of 6 929 deaths were reported in this omission survey, of which 1 556 were under-reported and 7 622 (95% CI: 7 593 ~ 7 651) were estimated by CMR. The total missing rate for 2 years was 23. 15%, 2 years total false negative rate difference was statistically significant (χ2 = 697.65, P <0.01). The 2-year total false negative rate of 0 ~ 4 years old group was 56.93%. The total false negative rate for men was 22.31%, and the false negative rate for women was 24.09%. There was no significant difference between them (χ2 = 3.40, P> 0.05). Conclusion There was a significant omission in the registration of cause of death in Shandong Province, and the inconsistent level of underreporting among layers, the high false negative rate in lower age groups and the incomplete registration of causes of death in lower age groups in some areas. The quality of the cause of death monitoring should be further strengthened and the report Data integrity, at the same time need to adjust the mortality rate stratified to more accurately and objectively evaluate the level of death of residents in Shandong Province.