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目的采用定群研究将对早产儿视网膜病(ROP)筛查率做出评价,对漏诊病人特性进行识别。研究设计我们使用了2005—2007年加利福尼亚围产期品质保健合作者的数据,进行了横断面研究。使用符合入选条件的标准,计算每家医院的筛查率。用多变量回归法评价病人临床和社会人口统计因素与漏诊率的相关性。结果 ROP筛查总漏诊率从2005年的18.6%降至2007年的12.8%。胎龄较大〔每增加1周,OR=1.25,95%CI(1.21,1.29)〕,出生体质量较高〔OR=1.13,95%CI(1.10,1.15)〕,单胞胎〔OR=1.2,95%CI(1.07,1.34)〕可能与漏诊率相关。II级新生儿重症监护病房和规模较小的新生儿重症监护病房更有可能漏诊。结论随着时间的推移,ROP筛查率有所改善,但是较大的和年长的风险婴儿未接受筛查。此外,加利福尼亚医院中的筛查率存在着较大差异。识别保健质量的差距,可为改善此易感人群ROP的筛查率、防止视力损害赢得机会。
Purpose The population-based study will evaluate the screening rate of retinopathy of prematurity (ROP) and identify characteristics of missed patients. Study Design We used cross-sectional data from 2005-2007 perinatal care partners in California. Use criteria that meet the eligibility criteria to calculate the screening rate for each hospital. Using Multivariate Regression to Evaluate the Correlation between Clinical and Social Demographic Factors and Misdiagnosis Rates in Patients. Results The total missed diagnosis rate of ROP screening decreased from 18.6% in 2005 to 12.8% in 2007. High birth weight (OR = 1.13, 95% CI (1.10, 1.15)], singleton fetuses (OR = 1.25, 95% CI 1.21, 1.29) 1.2,95% CI (1.07,1.34)] may be related to the misdiagnosis rate. Grade II neonatal intensive care units and smaller neonatal intensive care units are more likely to miss an appointment. Conclusions ROP screening rates have improved over time, but older and older risk infants have not been screened. In addition, screening rates in California hospitals vary widely. Identifying differences in the quality of care can improve screening rates for ROP in this susceptible population and prevent eye damage from gaining access.