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目的评价天津市2009年院内死亡病例信息报告质量,为进一步完善死因监测工作提供依据。方法分析天津市2009年死因监测网络直报数据及2008年现场漏报调查数据。结果 2009年院内死亡病例前5位死因分别为恶性肿瘤、心脏病、脑血管疾病、呼吸系统疾病、损伤和中毒,与户籍人口中的前5位死因构成顺序有所不同。根本死因编码错误率为0.41%,76.9%的死亡病例其根本死因诊断依据科学、可靠,77.7%的患者死亡后7 d内能够通过网络直报进行报告,99.7%的报告卡能够在网络直报后7 d内得到审核。院内死亡病例存在漏报,漏报率为4.5%,门、急诊漏报率高于住院。结论天津市住院死亡病例死因报告准确、有效,可以正确评估我市住院死亡人群的死因模式;但也存在不足,院内死亡病例的报告和管理仍是今后死因监测工作的重点。
Objective To evaluate the quality of information on hospital deaths in Tianjin in 2009 and provide the basis for further improvement of the cause of death monitoring. Methods To analyze the data of 2009 direct cause of death monitoring network in Tianjin and 2008 survey data of underreporting. Results The top 5 deaths in hospital in 2009 were malignant tumors, heart diseases, cerebrovascular diseases, respiratory diseases, injuries and poisonings, respectively, which were different from the order of the top five causes of death in the household population. The root cause of death coding error rate was 0.41%, 76.9% of the deaths were diagnosed based on scientific and reliable, 77.7% of patients died within 7 days after the report can be reported through the network, 99.7% of the report card in the network direct report After 7 days to be reviewed. In-hospital deaths are reported as underreporting, with a false-negative rate of 4.5%, with a false negative rate higher than that of hospitalized patients. Conclusion The death cause of hospitalized death cases in Tianjin is accurate and effective, which can correctly assess the pattern of the cause of death of in-city deaths in our city. However, there are still some shortcomings. The reporting and management of in-hospital deaths are still the focus of future work on the cause of death monitoring.