本文選題：法定傳染病報(bào)告 + 效果評價(jià)　； 參考：《鄭州大學(xué)》2008年碩士論文

【摘要】：人類與傳染病的斗爭是一個(gè)永恒的課題。疾病譜由傳染病轉(zhuǎn)為心、腦血管疾病和惡性腫瘤,人們思想上開始忽略了傳染病防治的重要性。近年來,由于全球化的加劇、交通和旅游業(yè)的發(fā)達(dá)、流動(dòng)人口的增多、抗生素的濫用以及環(huán)境因素等方面的影響,病毒變異和傳播的速度日益加快,導(dǎo)致已控制的傳染病卷土重來,新發(fā)傳染病不斷出現(xiàn)。傳染病加重了人們疾病的負(fù)擔(dān),在占世界人口約85%的發(fā)展中國家,傳染病是一個(gè)嚴(yán)重的公共衛(wèi)生問題。 傳染病疫情報(bào)告是傳染病管理工作的重要內(nèi)容,全面、及時(shí)、準(zhǔn)確的疫情報(bào)告是防止疫情蔓延的信息來源,而信息對于傳染病的預(yù)防和控制起著非常重要的作用。國外大多采用國家電子疾病監(jiān)測報(bào)告系統(tǒng),提高疫情報(bào)告的質(zhì)量。在我國,SARS疫情暴露了我國疫情報(bào)告系統(tǒng)“不完整、不準(zhǔn)確、不及時(shí)”的嚴(yán)重缺陷。2003年我國政府投入30億元加強(qiáng)法定傳染病信息系統(tǒng)建設(shè),2004年4月,全國建立起了法定傳染病網(wǎng)絡(luò)直報(bào)系統(tǒng)。該系統(tǒng)的啟用,使得我國傳染病疫情報(bào)告工作發(fā)生了質(zhì)的飛躍,傳染病疫情報(bào)告質(zhì)量有所提高,報(bào)告及時(shí)率得到很大改善。 目前,我國采用的網(wǎng)絡(luò)直報(bào)信息系統(tǒng),雖然提高了信息的傳遞速度,但是仍然解決不了信息源頭數(shù)據(jù)質(zhì)量低下的問題。網(wǎng)絡(luò)直報(bào)在農(nóng)村已經(jīng)逐漸延伸到鄉(xiāng)級,村級仍沿用傳統(tǒng)媒介傳遞疫情。我國是個(gè)農(nóng)業(yè)大國,農(nóng)村人口占全國總?cè)丝诘?0%,農(nóng)村居民66%的門診在村衛(wèi)生室,16%門診在鄉(xiāng)鎮(zhèn)衛(wèi)生院。農(nóng)村衛(wèi)生條件差,容易滋生和傳播傳染病,從2005年11月16日至2006年7月,我國共報(bào)告人感染高致病性禽流感19例,除2例為城鎮(zhèn)居民外,其余病例均為農(nóng)民或在農(nóng)村生活的兒童。因此,提高農(nóng)村法定傳染病報(bào)告質(zhì)量并利用科學(xué)、準(zhǔn)確的方法對法定傳染病報(bào)告的信息質(zhì)量進(jìn)行評價(jià),成為當(dāng)務(wù)之急。 目的 本研究為河南省世行貸款/國外贈(zèng)款中國傳染性非典型性肺炎及其它傳染病應(yīng)對項(xiàng)目的子課題(河南省農(nóng)村法定傳染病報(bào)告信息傳遞機(jī)制研究)內(nèi)容之一,旨在明確河南省農(nóng)村基層法定傳染病報(bào)告社會(huì)試驗(yàn)的干預(yù)措施以及效果,做好課題的進(jìn)一步推廣,并為政府決策者制定比較完善的方針政策提供科學(xué)依據(jù),完善河南省農(nóng)村法定傳染病報(bào)告的信息傳遞機(jī)制。 方法 1.研究對象:河南省的嵩縣和宜陽為本研究的2個(gè)樣本縣,研究對象包括其中的4個(gè)試驗(yàn)鄉(xiāng)鎮(zhèn)和4個(gè)對照鄉(xiāng)鎮(zhèn)共8個(gè)鄉(xiāng)鎮(zhèn)的所有疫情責(zé)任報(bào)告人,即鄉(xiāng)村醫(yī)生和鄉(xiāng)鎮(zhèn)衛(wèi)生院的醫(yī)務(wù)人員,共305人。試驗(yàn)組和對照組在2005年11月1日至2006年3月31日期間的法定傳染病報(bào)告情況,包括:醫(yī)生填寫報(bào)告卡片的完整性與準(zhǔn)確性、網(wǎng)絡(luò)直報(bào)系統(tǒng)中的傳染病重卡情況以及傳染病疫情的報(bào)告率與報(bào)告及時(shí)性等。 2.研究方法:采用多階段分層整群抽樣和單純隨機(jī)抽樣的方法確定樣本鄉(xiāng)鎮(zhèn),然后按隨機(jī)、均衡的原則把樣本鄉(xiāng)鎮(zhèn)分到試驗(yàn)組和對照組;運(yùn)用定性研究和定量研究相結(jié)合的方法對干預(yù)試驗(yàn)的效果進(jìn)行評價(jià)。 3.調(diào)查內(nèi)容:人員調(diào)查包括:調(diào)查對象的一般情況,法定傳染病診斷和法定傳染病報(bào)告的基本知識(shí),法定傳染病報(bào)告程序,傳染病報(bào)告培訓(xùn),傳染病報(bào)告督導(dǎo)和檢查,傳染病報(bào)告制度及執(zhí)行情況,傳染病報(bào)告的管理情況等。法定傳染病疫情報(bào)告調(diào)查包括:試驗(yàn)組和對照組的2005年11月至2006年3月間法定傳染病報(bào)告的疫情數(shù)據(jù)和信息,包括醫(yī)生填寫報(bào)告卡片的完整性與準(zhǔn)確性、網(wǎng)絡(luò)直報(bào)系統(tǒng)中的傳染病重卡情況以及傳染病疫情的報(bào)告率與報(bào)告及時(shí)性等。 4.數(shù)據(jù)的統(tǒng)計(jì)學(xué)處理:Epidata錄入數(shù)據(jù),Excel和SPSS12.0軟件進(jìn)行數(shù)據(jù)的分析。 結(jié)果 1.經(jīng)過干預(yù)后,試驗(yàn)組的調(diào)查對象在傳染病報(bào)告5個(gè)方面,即法定傳染病分類、傳染病診斷、報(bào)告卡填寫、報(bào)告時(shí)限、報(bào)告方式的知曉率均高于對照組,分別高出了37.41%、54.18%、30.31%、27.86%、13.40%。 2.經(jīng)Logistic回歸分析顯示,干預(yù)措施是提高法定傳染病報(bào)告相關(guān)知識(shí)知曉率的主要影響因素。 3.在干預(yù)階段,試驗(yàn)鄉(xiāng)鎮(zhèn)的報(bào)告發(fā)病率為1.89‰,對照鄉(xiāng)鎮(zhèn)的報(bào)告發(fā)病率為1.46‰;試驗(yàn)鄉(xiāng)鎮(zhèn)在上一年同一時(shí)期的報(bào)告發(fā)病率為1.18‰。 4.試驗(yàn)鄉(xiāng)鎮(zhèn)與對照鄉(xiāng)鎮(zhèn)相比,報(bào)告卡質(zhì)量提高了11.25%;重報(bào)率和漏報(bào)率分別降低了30.86%和56.33%,報(bào)告及時(shí)率提高了36.12%,以上指標(biāo)兩組之間的差異有統(tǒng)計(jì)學(xué)意義(P＜0.05)。 5.法定傳染病疫情報(bào)告信息質(zhì)量綜合指數(shù),試驗(yàn)鄉(xiāng)鎮(zhèn)高于對照鄉(xiāng)鎮(zhèn)。 結(jié)論 課題組采取的干預(yù)措施科學(xué)、合理、有效,可進(jìn)一步推廣。首先,法定傳染病診斷知識(shí)的培訓(xùn)、基本報(bào)告工具的配備和報(bào)告方式、時(shí)間、程序的顯著增加了疫情責(zé)任報(bào)告人報(bào)告法定傳染病的能力,提高了法定傳染病的報(bào)告發(fā)病率;其次,醫(yī)務(wù)人員報(bào)告知識(shí)和網(wǎng)絡(luò)直報(bào)人員網(wǎng)絡(luò)直報(bào)知識(shí)的培訓(xùn),提高了傳染病報(bào)告卡填寫的質(zhì)量,縮短了診斷至填卡、填卡至報(bào)告和報(bào)告至審核的時(shí)間,降低了重復(fù)報(bào)告率;法定傳染病報(bào)告法律、法規(guī)的宣傳,督導(dǎo)制度、獎(jiǎng)懲制度的制定和實(shí)施,減少了各個(gè)環(huán)節(jié)的漏報(bào)率。 為了進(jìn)一步提高農(nóng)村法定傳染病報(bào)告的信息質(zhì)量,根據(jù)干預(yù)措施實(shí)施提出以下政策建議:加大傳染病報(bào)告的監(jiān)督執(zhí)法力度;、建立健全法定傳染病報(bào)告的激勵(lì)機(jī)制;廣泛采取多種培訓(xùn)方式,加強(qiáng)對基層醫(yī)務(wù)人員的在職培訓(xùn),特別要加強(qiáng)對廣大鄉(xiāng)村醫(yī)生的培訓(xùn)力度。
[Abstract]:The struggle between human and infectious diseases is an eternal subject. The disease spectrum is transformed from infectious disease to heart, cerebrovascular disease and malignant tumor. People have neglected the importance of the prevention and control of infectious diseases. In recent years, due to the intensification of globalization, the development of transportation and tourism, the increase of the mouth of the mobile people, the abuse of antibiotics and the environmental factors. The influence of the virus, the speed of virus variation and transmission is accelerating, which leads to the reemergence of controlled infectious diseases and the emergence of new infectious diseases. Infectious diseases aggravate the burden of people's disease. In the developing countries, which account for about 85% of the world's population, infectious diseases are a serious public health problem.
Infectious disease report is an important content of the management of infectious diseases. Comprehensive, timely and accurate epidemic report is the information source to prevent the spread of the epidemic, and information plays a very important role in the prevention and control of infectious diseases. Most of the foreign countries use the national electronic disease monitoring report system to improve the quality of the epidemic report. In China, SAR The epidemic report system of S has exposed the serious defect of "incomplete, inaccurate, and not timely" in China's epidemic reporting system. In the year.2003, our government invested 3 billion yuan to strengthen the construction of the legal infectious disease information system. In April 2004, the national network direct reporting system of the legal infectious disease was established. The system has enabled the reporting work of infectious diseases in China to take place. The quality of reporting of infectious diseases has improved and the reporting rate has been greatly improved.
At present, the network direct information system adopted in China has improved the speed of information transmission, but it still can not solve the problem of low quality of information source data. The network direct report has gradually extended to the rural level in the countryside. The village level still uses the traditional media to transmit the epidemic situation. China is a big agricultural country, and the rural population accounts for 70% of the total population of the country. 66% of the rural residents were in the village health room and the 16% outpatients were in the township health centers. The rural health conditions were poor, and the infectious diseases were easy to grow and spread. From November 16, 2005 to July 2006, 19 cases of highly pathogenic avian influenza were reported in China. Except for 2 cases of urban residents, the other cases were all farmers or children living in the countryside. It is urgent to assess the quality of notifiable infectious diseases in rural areas and to evaluate the information quality of legal infectious diseases reports scientifically and accurately.
objective
This study is one of the sub subjects of the Henan provincial bank loan / foreign grant for infectious atypical pneumonia and other infectious diseases (the research on the information transmission mechanism of the report of the rural notifiable infectious diseases in Henan province). The purpose of this study is to clarify the intervention measures and effects of the social test of the rural grass-roots legal infectious diseases in Henan Province, and to do a good lesson. Further promotion of the problem, and provide scientific basis for the government policy makers to formulate more perfect policies and policies, and improve the information transmission mechanism of the report of the rural legal infectious diseases in Henan province.
Method
1. research subjects: Songxian and Yiyang in Henan province were 2 sample counties of this study. The subjects included all of the 4 pilot towns and 4 control towns and 8 townships in all 8 villages and towns, namely, the rural doctors and the medical staff of the township hospitals, with 305 people. The test group and the control group were from November 1, 2005 to March 2006 31. The reporting of notifiable infectious diseases included: the integrity and accuracy of the doctor to fill in the report card, the situation of the infectious disease heavy card in the network direct reporting system, the reporting rate and the timeliness of the epidemic situation.
2. research method: the sample towns were determined by multi-stage stratified cluster sampling and simple random sampling, then the sample towns were divided into the experimental group and the control group according to the principle of random and equilibrium, and the effect of the intervention test was evaluated by the combination of qualitative and quantitative research.
3. investigation content: the survey included the general situation of the subject, the basic knowledge of the diagnosis of the legal contagion and the report of the notifiable infectious disease, the procedure of the report of the legal communicable disease, the training of the infectious disease report, the supervision and examination of the report of the infectious disease, the system and execution of the infectious disease report, the management of the infectious disease report, and so on. The investigation included the data and information of the report of the notifiable infectious disease between the test group and the control group from November 2005 to March 2006, including the integrity and accuracy of the doctors filling in the report cards, the situation of the infectious disease heavy cards in the network direct reporting system, the reporting rate and the timeliness of the epidemic situation.
4. statistical processing of data: Epidata input data, Excel and SPSS12.0 software for data analysis.
Result
1. after the dry prognosis, the subjects of the test group were in 5 aspects of the report of infectious diseases, namely, the classification of the notifiable infectious diseases, the diagnosis of infectious diseases, the filling of the report cards, the time limit of the report, and the rate of awareness of the reporting methods higher than those of the control group, which were 37.41%, 54.18%, 30.31%, 27.86%, 13.40% respectively.
2. Logistic regression analysis showed that intervention measures were the main factors to increase the awareness rate of notifiable infectious diseases related knowledge.
3. in the intervention stage, the reported incidence of the test township was 1.89 per thousand, the reported incidence of the control township was 1.46 per thousand, and the reported incidence of the test Township in the same period of last year was 1.18 per thousand.
4. compared with the control Township, the quality of the report card was increased by 11.25%, the rate of rereporting and the rate of missing report were reduced by 30.86% and 56.33% respectively. The timely rate of the report was increased by 36.12%, and the difference between the two groups was statistically significant (P < 0.05).
5. the comprehensive index of the information quality of the epidemic report of legal infectious diseases is higher than that of the control villages and towns.
conclusion
The intervention measures taken by the group are scientific, reasonable and effective, and can be further promoted. First, the training of the diagnostic knowledge of the legal infectious diseases, the allocation and reporting of the basic reporting tools, the time and the procedure have significantly increased the ability of the reporting person to report the legal infectious disease, and increased the incidence of the reporting of the legal infectious diseases; secondly, the medical workers. Staff report knowledge and network direct report personnel training of direct information network, improve the quality of the report card filling, shorten the diagnosis to the filling card, fill the card to report and report to the time, reduce the repetition rate; legal infectious disease report law, regulations, supervision system, the formulation and implementation of the reward and punishment system, reduced The rate of failure in each link.
In order to further improve the information quality of the report of the rural legal infectious diseases, the following policy suggestions are put forward according to the intervention measures: to strengthen the supervision and enforcement of the report of infectious diseases; to establish and improve the incentive mechanism for the report of the legal infectious diseases; to adopt a wide variety of training methods to strengthen the on-the-job training for the medical staff at the grass-roots level, and to strengthen the practice in particular. The training of the vast rural doctors.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2008
【分類號】：R181.8

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 馬家奇;21世紀(jì)中國互聯(lián)網(wǎng)絡(luò)的發(fā)展對傳染病疫情報(bào)告系統(tǒng)的沖擊[J];中國公共衛(wèi)生管理;2003年03期

2 王德煥;張惠麗;于世和;張艷麗;;法定傳染病網(wǎng)絡(luò)直報(bào)信息質(zhì)量評價(jià)[J];中國公共衛(wèi)生管理;2006年05期

3 徐凌中,柳麗華,王永杰;效用指標(biāo)的測量方法及其研究進(jìn)展[J];國外醫(yī)學(xué)(衛(wèi)生經(jīng)濟(jì)分冊);2001年02期

4 吳秀玲;呂煒;許艷云;黃麗華;;廣西法定傳染病疫情網(wǎng)絡(luò)直報(bào)質(zhì)量分析[J];應(yīng)用預(yù)防醫(yī)學(xué);2006年05期

5 李新華;張偉;夏梓紅;;學(xué)齡前集體兒童行為問題影響因素的多水平模型[J];貴陽醫(yī)學(xué)院學(xué)報(bào);2006年01期

6 王淑萍,李穎琰,謝婧,陳益洲,朱謙;河南省西部某縣2003年居民法定傳染病漏報(bào)調(diào)查分析[J];疾病監(jiān)測;2005年01期

7 馬家奇,王麗萍,戚曉鵬,張春曦,郭青,葛輝,郭巖;2004年法定傳染病報(bào)告信息質(zhì)量分析[J];疾病監(jiān)測;2005年05期

8 郭曉榮;郁惠蓮;邱琳;;陜西省2004年傳染病疫情報(bào)告信息質(zhì)量評價(jià)[J];疾病監(jiān)測;2005年10期

9 李琳;單愛蘭;高璐;陳靜;呂杰;劉輝;何海艷;;天津市2004年醫(yī)療機(jī)構(gòu)傳染病報(bào)告質(zhì)量評估[J];疾病監(jiān)測;2005年11期

10 馬家奇;戚曉鵬;施曉明;王麗萍;張春曦;郭青;郭巖;;2005年傳染病網(wǎng)絡(luò)直報(bào)工作評價(jià)[J];疾病監(jiān)測;2006年11期

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