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目的了解珠海市香洲区社区卫生服务机构传染病上报的漏报情况,分析并提出相应措施。方法 2013年8月共调查社区卫生服务机构80家,其中,社区卫生服务中心13家(公立4家),社区卫生服务站67家。查阅其2010—2012年门诊诊断为传染病的电子病历。对社区医疗机构的传染病报告管理情况进行调查,随机抽查不同月份、不同病种的门诊日志、化验室登记,然后同疫情网络直报的数据进行核对,相同者视为报告病例,疫情网未报告者均为漏报病例。结果 80家社区卫生服务机构3年共诊断传染病7 853例,2010年2 640例,漏报220例,漏报率8.3%;2011年2 395例,漏报130例,漏报率5.4%;2012年2 818例,漏报80例,漏报率2.8%。将2010—2012年社区卫生服务机构的常见传染病有手足口病、其它感染性腹泻、肺结核、出血性结膜炎、流行性腮腺炎进行漏报分析,结果漏报率较高的是出血性结膜炎和流行性腮腺炎。将2010—2012年公立与民营卫生服务机构的传染病漏报情况比较,结果民营社区卫生服务机构漏报率较高。将2010—2012年社区卫生服务中心与社区卫生服务站的传染病漏报情况分析,结果社区卫生服务站漏报率较高于社区卫生服务中心。结论政府应设立社区人员对传染病管理的培训和考核,重点加强民营社区卫生服务机构工作人员培训,民营社区卫生服务机构建立用人留人机制,完善传染病网络报告系统,从而降低传染病漏报率。
Objective To understand the omission of reporting of infectious diseases reported by community health service agencies in Xiangzhou District of Zhuhai City, and to analyze and propose corresponding measures. Methods Totally 80 community health service agencies were investigated in August 2013, including 13 community health service centers (4 public) and 67 community health service stations. Check out their electronic medical records for outpatient diagnosis of infectious diseases in 2010-2012. Conduct surveys on the management of infectious disease reports in community medical institutions, randomly select outpatient diaries and laboratory registrations in different months and different types of diseases, and then check with the direct reporting data of the epidemic network. The same is considered as the reported case and the epidemic network is not Reporters are all missing cases. Results A total of 7 853 cases of infectious diseases were diagnosed in 80 community health service institutions in 2003, 2 640 cases in 2010, 220 cases were missed and 3.3% cases were missed; in 2011 2 395 cases were missed, 130 cases were missed, 5.4% ; 2,818 cases in 2012, 80 cases were under-reported, and the omission rate was 2.8%. The common communicable diseases of community health service agencies from 2010 to 2012 were hand-foot-mouth disease, other infectious diarrhea, tuberculosis, hemorrhagic conjunctivitis and mumps. The results of the omission report were hemorrhagic conjunctiva Inflammation and Mumps. The public health and private health service agencies in 2010-2012 compared to the omission of infectious diseases, the results of private community health service agencies a higher rate of omission. Analysis of the omission of communicable diseases in community health service centers and community health service stations from 2010 to 2012 showed that the omission rate of community health service stations was higher than that of community health service centers. Conclusion The government should set up training and assessment of infectious disease management by community staff, with emphasis on training of staff in private community health service agencies, establishment of a mechanism for employing people by others in private community health service institutions and improvement of the network reporting system for infectious diseases so as to reduce the omission of communicable diseases rate.