摘要
目的分析评价目前我国(未包括香港、澳门及台湾地区,以下同)基层医疗机构的传染病诊断报告现状,为进一步加强基层医疗机构的公共卫生服务能力提供参考。方法采用SAS 9.2统计软件对2012年度全国基层医疗机构所诊断报告的法定传染病个案数据库进行分析处理。采用Excel软件制作统计图表,Arc GIS 9.3软件制作统计地图。结果 2012年全国基层医疗机构数为41 865家,占网络直报机构总数的62%,网络报告率为92%,西部地区网络报告率最低。当年基层医疗机构报告传染病745 407例,占全国报告总数的11%,无甲类和按甲类管理传染病诊断报告,主要诊断报告的病种为丙类传染病,占报告病例总数的63%。东、中、西部地区,城、乡基层医疗机构间无明显差异,均以报告丙类传染病为主。基层医疗机构报告病例的实验室诊断率为22%,低于县级以上医院;病例及时报告率达98%,高于县级以上医院,但涂(+)和菌(-)肺结核病例报告的及时率较低。结论我国基层医疗机构数量庞大,但传染病的发现与诊断能力有限,病例的实验室诊断率偏低,但报告及时性较好。国家应进一步加强对基层医疗机构的硬件和基础设施建设,落实对其传染病诊断报告专业技术的培训与指导,提升其常见传染病诊断与报告的能力与意识,尤其是在西部地区。
Objective To evaluate the diagnosis and reporting of communicable diseases in the basic medical institutions in the mainland of China and provide evidence to improve their capacities for public health service. Methods Analysis was conducted on the reporting data of communicable diseases by basic medical institutions in China in 2012 with SAS 9.2 software. Related statistical tables and figures were made by using Microsoft Excel 2007 and statistical maps were made with software Arc GIS 9.3. Results In 2012, there were 41 865 basic medical institutes in China, accounting for 62% of total medical institutions included in network direct reporting system. The nationwide network direct reporting rate was 92%. The network direct reporting rate was lowest in western region. A total of 745 407 cases of communicable diseases were reported by basic medical institutions in 2012, accounting for 11% of the national total. No diseases in class A or other highly infectious diseases included in class A were reported. Most diseases diagnosed and reported were in class C, accounting for 63% of the total. The differences in diseases diagnosed and reported among the basic medical institutions in eastern, central and western regions had no statistical significance. In basic medical institutions, the laboratory confirmation rate of reported cases was about 22%, lower than that in county level and above hospitals, the timely reporting rate of the diseases was 98%, higher than that in county level and above hospitals, but the timely reporting rate of smear positive and bacteriological negative pulmonary tuberculosis was low. Conclusion There are a large number of basic medical institutions in China, but their capacities of disease clinical diagnosis and laboratory confirmation are limited. It is necessary to increase the investment for basic medical institutions and conduct training on communicable disease diagnosis and reporting among their staff, particularly in western region.
出处
《疾病监测》
CAS
2014年第3期176-180,共5页
Disease Surveillance
基金
国家科技重大专项(No.2012ZX10004-201)
卫生部公益性行业科研专项(No.201202006)~~
关键词
基层医疗机构
法定传染病
监测
basic medical institutions
notifiable communicable disease
surveillance
