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[目的]了解四川省医疗机构法定传染病的漏报情况,为进一步提高传染病网络直报工作效率和质量提供理论依据。[方法]对2007～2008年四川省传染病漏报调查原始资料进行统计分析。[结果]2007～2008年四川省各级医疗机构年均漏报率9.64%,其中乙、丙类传染病漏报率分别为9.03%、11.64%。漏报率最高的前5位病种依次为风疹(26.32%)、猩红热(23.08%)、流感(19.23%)、丙肝(18.18%)、其他感染性腹泻病(17.06%)。各级医疗机构传染病漏报率差异有统计学意义(χ2=66.199,P﹤0.001),且随级别降低其漏报率呈上升趋势(趋势χ2=47.205,P﹤0.001),其中省级医疗机构传染病漏报率为3.33%,市州级6.69%,县区级8.27%,乡镇级21.47%,个体医疗机构19.05%。两年抽查卡片平均及时率为88.47%,完整率85.32%,准确率80.08%,卡片录入一致率79.98%。各级医疗机构临床医生对传染病知识掌握情况差异有统计学意义(F=6.088,P﹤0.001),省级临床医生对传染病知识掌握程度高于其他三级;防保医生对传染病知识掌握情况比临床医生好,差异有统计学意义(t=4.716,P﹤0.001)。[结论]四川省法定传染病报告管理工作形势仍然严峻,各级医疗卫生部门应重视传染病报告工作和制度建设,加强医务人员依法报告传染病意识和相关知识培训,进一步提高传染病报告效率和质量。
[Objective] To understand the omission of notifiable infectious diseases in medical institutions in Sichuan Province and provide theoretical basis for further improving the efficiency and quality of direct reporting of infectious diseases network. [Methods] The statistical data of the original data of the underreporting investigation of infectious diseases in Sichuan Province from 2007 to 2008 were analyzed. [Results] The annual average omission rate of medical institutions at all levels in Sichuan Province from 2007 to 2008 was 9.64%. The omission of infectious diseases of Class B and C were 9.03% and 11.64% respectively. The top 5 cases with the highest false negatives were rubella (26.32%), scarlet fever (23.08%), flu (19.23%), hepatitis C (18.18%) and other infectious diarrheal diseases (17.06%). The rate of omission of infectious diseases at all levels of medical institutions was significantly different (χ2 = 66.199, P <0.001), and the rate of omission increased with the decrease of grade (trend χ2 = 47.205, P <0.001) Agency infectious disease omission rate of 3.33%, municipal state 6.69%, county level 8.27%, township level 21.47%, 19.05% of individual medical institutions. The average check-in rate in two years was 88.47%, the completeness rate was 85.32%, the accuracy rate was 80.08%, and the card entry consistency rate was 79.98%. The clinicians at all levels of medical institutions had statistically significant knowledge of infectious diseases (F = 6.088, P <0.001), and provincial doctors had more knowledge of infectious diseases than the other three; Grasp better than the clinician, the difference was statistically significant (t = 4.716, P <0.001). [Conclusion] The situation of legal management of notifiable infectious diseases in Sichuan is still grim. Medical and health departments at all levels should pay close attention to the work and system of infectious disease reporting, strengthen medical staffs to report infectious disease awareness and relevant knowledge according to law, and further improve the efficiency of reporting infectious diseases and quality.