Article(id=1241102821618151682, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102813938380911, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202404309, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1713369600000, receivedDateStr=2024-04-18, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773831571249, onlineDateStr=2026-03-18, pubDate=1724515200000, pubDateStr=2024-08-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773831571249, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773831571249, creator=13701087609, updateTime=1773831571249, updator=13701087609, issue=Issue{id=1241102813938380911, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='16', pageStart='2881', pageEnd='3072', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773831569418, creator=13701087609, updateTime=1773831807198, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241103811318706322, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102813938380911, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241103811318706323, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241102813938380911, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2988, endPage=2992, ext={EN=ArticleExt(id=1241102823207792905, articleId=1241102821618151682, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Investigation on the status of infectious disease reports based on automatic exchange of regional platforms, Sichuan, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the status quo of infectious disease reports automatically exchanged by secondary and above medical institutions in Sichuan province based on regional platform, and provide basis for improving the work on automatic exchange of infectious disease information reports in the next step.

Methods

Check and calculate the success rates of exchange and rough exchange through the system, the use of the infectious disease reporting management related systems was investigated by questionnaire survey. T-test and chi-square test were used for comparison between groups, and spearman correlation analysis was used for correlation.

Results

From July to September 2023, the exchange success rate in 68 medical institutions was 92.67%, and the success rate of crude exchange reached 95.87%. Compared with other level medical institutions, municipal medical institutions had higher success rate of exchange and crude exchange, and longer time interval to realize automatic exchange. The exchange success rate was positively correlated with the time interval to realize automatic exchange (r=0.44, P<0.001) and the crude exchange success rate (r=0.51, P<0.001). More than 90% of the institutions had HIS, LIS, PACS. 77.94% of the institutions could automatically generate the report card, more than 80% had the report card management and information statistics query functions. 73.53% realized the automatic early warning of infectious disease report card, and 25% of the institutions reported the card forcibly after the early warning. 88.24% felt that the workload of infectious disease report was reduced after automatic exchange.

Conclusion

The success rate of automatic exchange and the success rate of crude exchange in medical institutions were higher overall, municipal medical institutions were higher than other levels of medical institutions. The construction rate of basic information system in medical institutions was high, but the basic functions of automatic exchange were not perfect. Automatic exchange improves the efficiency of reporting to some extent, but it still could not completely replace manual reporting.

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目的

为了解四川省二级及以上医疗机构基于区域平台自动交换的传染病报告现状,为下一步完善传染病信息报告自动交换工作提供依据。

方法

通过系统查看计算交换成功率、粗交换成功率,现场通过问卷调查了解传染病报告管理相关系统使用情况。R软件用于统计分析。

结果

2023年7—12月68家医疗机构交换成功率为92.67%,粗交换成功率达到95.87%。市级与其他级别医疗机构比较,交换成功率、粗交换成功率较高,实现自动交换时间间隔较长。交换成功率与实现自动交换时间间隔(r=0.44,P<0.001)、粗交换成功率(r=0.51,P<0.001)均呈正相关。90%以上的机构有医院信息系统(Hospital Information System,HIS)、实验室信息系统(Laboratory Information System,LIS)、影像归档和通信系统(Picture Archiving and Communication Systems,PACS)。77.94%的机构能自动生成传报卡,80%以上具有传报卡管理和信息统计查询功能。73.53%实现了传染病报告卡(传报卡)的自动预警,预警后强制报卡的机构占比25%。自动交换后感觉工作量减轻的占比88.24%。

结论

医疗机构交换成功率及粗交换成功率整体较高,市级高于其他级别医疗机构。医疗机构基本信息系统建设率较高,但自动交换相关基础功能还不完善。自动交换一定程度上提高了报告的效率,但仍不能完全替代手工报卡。

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吕强,E-mail:
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李羚(1988—),女,硕士研究生,副主任医师,研究方向:传染病疾病控制

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李羚(1988—),女,硕士研究生,副主任医师,研究方向:传染病疾病控制

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Automatic exchange of different levels of medical institutions

, figureFileSmall=null, figureFileBig=null, tableContent=
机构类型传染病网络直报系统报卡数(张)省交换平台交换卡片总数(张)省交换平台成功交换数(张)粗交换成功率
(%)
交换成功率
(%)
实现自动交换时间间隔(月)
省级22 69021 97320 11391.5488.6418.20±9.49
市级98 20294 75992 19297.2993.8820.10±8.86
县区级31 10330 19028 55494.5891.8011.64±5.16
合计151 995146 922140 85995.8792.6715.37±8.11
t/χ21 355.99a594.89a4.300a
P<0.001<0.001<0.001
), ArticleFig(id=1241102828974961165, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=CN, label=表1, caption=

不同级别医疗机构自动交换情况

, figureFileSmall=null, figureFileBig=null, tableContent=
机构类型传染病网络直报系统报卡数(张)省交换平台交换卡片总数(张)省交换平台成功交换数(张)粗交换成功率
(%)
交换成功率
(%)
实现自动交换时间间隔(月)
省级22 69021 97320 11391.5488.6418.20±9.49
市级98 20294 75992 19297.2993.8820.10±8.86
县区级31 10330 19028 55494.5891.8011.64±5.16
合计151 995146 922140 85995.8792.6715.37±8.11
t/χ21 355.99a594.89a4.300a
P<0.001<0.001<0.001
), ArticleFig(id=1241102829088207382, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=EN, label=Table 2, caption=

Comparison of related factors in medical institutions with different exchange success rates

, figureFileSmall=null, figureFileBig=null, tableContent=
因素交换成功率≥95%
/n(%)
交换成功率<95%
/n(%)
t/χ2P
实现自动交换时间间隔(月)18.27±6.1112.95±8.93-2.7330.008
粗自动交换率(%)2 644.440<0.001
省交换平台成功交换数(张)98 730(97.67)42 129(91.91)
省交换平台未成功交换数(张)2 355(2.33)3 708(8.09)
), ArticleFig(id=1241102829197259294, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=CN, label=表2, caption=

不同交换成功率医疗机构相关因素比较

, figureFileSmall=null, figureFileBig=null, tableContent=
因素交换成功率≥95%
/n(%)
交换成功率<95%
/n(%)
t/χ2P
实现自动交换时间间隔(月)18.27±6.1112.95±8.93-2.7330.008
粗自动交换率(%)2 644.440<0.001
省交换平台成功交换数(张)98 730(97.67)42 129(91.91)
省交换平台未成功交换数(张)2 355(2.33)3 708(8.09)
), ArticleFig(id=1241102829297922605, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=EN, label=Table 3, caption=

Usage authority of basic information systems for doctors in Preventive care Department of medical institutions [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
系统浏览查询导出均有
HIS门诊68(100.00)68(100.00)68(100.00)68(100.00)
HIS住院66(97.06)66(97.06)65(95.59)65(95.59)
LIS52(76.47)52(76.47)37(54.41)35(51.47)
PACS45(66.18)44(64.71)25(36.76)23(33.82)
Z-8.581
P<0.001
), ArticleFig(id=1241102829377614389, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=CN, label=表3, caption=

医疗机构防保科医生基本信息系统使用权限情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
系统浏览查询导出均有
HIS门诊68(100.00)68(100.00)68(100.00)68(100.00)
HIS住院66(97.06)66(97.06)65(95.59)65(95.59)
LIS52(76.47)52(76.47)37(54.41)35(51.47)
PACS45(66.18)44(64.71)25(36.76)23(33.82)
Z-8.581
P<0.001
), ArticleFig(id=1241102829482472000, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=EN, label=Table 4, caption=

Related functions of infectious disease report card in medical institutions

, figureFileSmall=null, figureFileBig=null, tableContent=
报告管理功能合计
n=68)
省级
n=5)
市级
n=26)
县区级
n=37)
自动生成传报卡53(77.94)4(80.00)23(88.46)26(70.27)
传报卡管理58(85.29)4(80.00)25(96.15)29(78.38)
信息统计查询57(83.82)4(80.00)25(96.15)28(75.68)
), ArticleFig(id=1241102829583135306, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=CN, label=表4, caption=

医疗机构传染病报告卡相关功能

, figureFileSmall=null, figureFileBig=null, tableContent=
报告管理功能合计
n=68)
省级
n=5)
市级
n=26)
县区级
n=37)
自动生成传报卡53(77.94)4(80.00)23(88.46)26(70.27)
传报卡管理58(85.29)4(80.00)25(96.15)29(78.38)
信息统计查询57(83.82)4(80.00)25(96.15)28(75.68)
), ArticleFig(id=1241102829687992916, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=EN, label=Table 5, caption=

Statistics of information automatically captured and filled in during the process of generating infectious disease report card by medical institutions [n(%)]

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信息完全可以大部分可以小部分可以完全不可以
报卡信息31(58.49)13(24.53)6(11.32)3(5.66)
病人基本信息36(67.92)13(24.53)4(7.55)0(0.00)
病人发病及诊断信息20(37.74)10(18.87)13(24.53)10(18.87)
附卡相关信息16(30.19)13(24.53)12(22.64)12(22.64)
), ArticleFig(id=1241102829771879005, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=CN, label=表5, caption=

医疗机构生成传染病报告卡自动抓取填写的信息统计[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
信息完全可以大部分可以小部分可以完全不可以
报卡信息31(58.49)13(24.53)6(11.32)3(5.66)
病人基本信息36(67.92)13(24.53)4(7.55)0(0.00)
病人发病及诊断信息20(37.74)10(18.87)13(24.53)10(18.87)
附卡相关信息16(30.19)13(24.53)12(22.64)12(22.64)
), ArticleFig(id=1241102829885125226, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=EN, label=Table 6, caption=

Early-warning functions of medical institution system

, figureFileSmall=null, figureFileBig=null, tableContent=
事件合计(n=68)省级(n=5)市级(n=26)县区级(n=37)χ2P
甲类及甲管传染病36(52.94)1(20.00)19(73.77)16(43.24)6.8510.009
迟报38(55.88)1(20.00)17(65.38)20(54.05)1.5420.214
罕见病、新发病21(30.88)0(0.00)10(38.46)11(29.73)1.1330.287
聚集性疫情22(32.35)1(20.00)10(38.46)11(29.73)0.7180.397
院内重卡43(63.24)4(80.00)19(73.08)20(54.05)1.7540.185
均没有18(26.47)1(20.00)5(19.23)12(32.43)1.1340.287
), ArticleFig(id=1241102829989982837, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241102821618151682, language=CN, label=表6, caption=

医疗机构系统预警功能

, figureFileSmall=null, figureFileBig=null, tableContent=
事件合计(n=68)省级(n=5)市级(n=26)县区级(n=37)χ2P
甲类及甲管传染病36(52.94)1(20.00)19(73.77)16(43.24)6.8510.009
迟报38(55.88)1(20.00)17(65.38)20(54.05)1.5420.214
罕见病、新发病21(30.88)0(0.00)10(38.46)11(29.73)1.1330.287
聚集性疫情22(32.35)1(20.00)10(38.46)11(29.73)0.7180.397
院内重卡43(63.24)4(80.00)19(73.08)20(54.05)1.7540.185
均没有18(26.47)1(20.00)5(19.23)12(32.43)1.1340.287
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四川省基于区域平台自动交换的传染病报告现状调查
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李羚 , 张雪峰 , 刘润友 , 张云娜 , 吕强
现代预防医学 | 卫生政策与管理 2024,51(16): 2988-2992
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现代预防医学 | 卫生政策与管理 2024, 51(16): 2988-2992
四川省基于区域平台自动交换的传染病报告现状调查
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李羚, 张雪峰, 刘润友, 张云娜, 吕强
作者信息
  • 四川省疾病预防控制中心,四川 成都 610041
  • 李羚(1988—),女,硕士研究生,副主任医师,研究方向:传染病疾病控制

通讯作者:

吕强,E-mail:
Investigation on the status of infectious disease reports based on automatic exchange of regional platforms, Sichuan
Ling LI, Xue-feng ZHANG, Run-you LIU, Yun-na ZHANG, Qiang LV
Affiliations
  • Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China
出版时间: 2024-08-25 doi: 10.20043/j.cnki.MPM.202404309
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目的

为了解四川省二级及以上医疗机构基于区域平台自动交换的传染病报告现状,为下一步完善传染病信息报告自动交换工作提供依据。

方法

通过系统查看计算交换成功率、粗交换成功率,现场通过问卷调查了解传染病报告管理相关系统使用情况。R软件用于统计分析。

结果

2023年7—12月68家医疗机构交换成功率为92.67%,粗交换成功率达到95.87%。市级与其他级别医疗机构比较,交换成功率、粗交换成功率较高,实现自动交换时间间隔较长。交换成功率与实现自动交换时间间隔(r=0.44,P<0.001)、粗交换成功率(r=0.51,P<0.001)均呈正相关。90%以上的机构有医院信息系统(Hospital Information System,HIS)、实验室信息系统(Laboratory Information System,LIS)、影像归档和通信系统(Picture Archiving and Communication Systems,PACS)。77.94%的机构能自动生成传报卡,80%以上具有传报卡管理和信息统计查询功能。73.53%实现了传染病报告卡(传报卡)的自动预警,预警后强制报卡的机构占比25%。自动交换后感觉工作量减轻的占比88.24%。

结论

医疗机构交换成功率及粗交换成功率整体较高,市级高于其他级别医疗机构。医疗机构基本信息系统建设率较高,但自动交换相关基础功能还不完善。自动交换一定程度上提高了报告的效率,但仍不能完全替代手工报卡。

区域平台  /  自动交换  /  传染病报告
Objective

To understand the status quo of infectious disease reports automatically exchanged by secondary and above medical institutions in Sichuan province based on regional platform, and provide basis for improving the work on automatic exchange of infectious disease information reports in the next step.

Methods

Check and calculate the success rates of exchange and rough exchange through the system, the use of the infectious disease reporting management related systems was investigated by questionnaire survey. T-test and chi-square test were used for comparison between groups, and spearman correlation analysis was used for correlation.

Results

From July to September 2023, the exchange success rate in 68 medical institutions was 92.67%, and the success rate of crude exchange reached 95.87%. Compared with other level medical institutions, municipal medical institutions had higher success rate of exchange and crude exchange, and longer time interval to realize automatic exchange. The exchange success rate was positively correlated with the time interval to realize automatic exchange (r=0.44, P<0.001) and the crude exchange success rate (r=0.51, P<0.001). More than 90% of the institutions had HIS, LIS, PACS. 77.94% of the institutions could automatically generate the report card, more than 80% had the report card management and information statistics query functions. 73.53% realized the automatic early warning of infectious disease report card, and 25% of the institutions reported the card forcibly after the early warning. 88.24% felt that the workload of infectious disease report was reduced after automatic exchange.

Conclusion

The success rate of automatic exchange and the success rate of crude exchange in medical institutions were higher overall, municipal medical institutions were higher than other levels of medical institutions. The construction rate of basic information system in medical institutions was high, but the basic functions of automatic exchange were not perfect. Automatic exchange improves the efficiency of reporting to some extent, but it still could not completely replace manual reporting.

Regional platform  /  Automatic exchange  /  Infectious disease report
李羚, 张雪峰, 刘润友, 张云娜, 吕强. 四川省基于区域平台自动交换的传染病报告现状调查. 现代预防医学, 2024 , 51 (16) : 2988 -2992 . DOI: 10.20043/j.cnki.MPM.202404309
Ling LI, Xue-feng ZHANG, Run-you LIU, Yun-na ZHANG, Qiang LV. Investigation on the status of infectious disease reports based on automatic exchange of regional platforms, Sichuan[J]. Modern Preventive Medicine, 2024 , 51 (16) : 2988 -2992 . DOI: 10.20043/j.cnki.MPM.202404309
传染病监测承担着收集疫情信息、监测疫情变化趋势、及早发现流行和暴发等多项任务,是传染病防控工作的重要组成部分[1]。20世纪50-70年代,我国全面建立了常规传染病报告体系及制度, 2003年SARS后,建立了“纵向到底,横向到边”的传染病监测系统,传染病监测质量得到了极大的提高[2]。但随着社会的飞速发展,传染病面临的报告质量和效率问题依然存在。随着科学技术的不断进步,医疗机构HIS系统的上线使用,基于HIS与传染病网络直报系统的自动交换逐步得到推广。自动交换打通了报卡的“最后一公里”,省去了手工录入环节,减轻了报卡负担,也保证了数据的及时、完整、准确和一致性[3-4]
2023年四川省积极推进二级及以上医疗机构传染病报告自动交换,并于年中初步形成医院信息系统-四川省传染病交换平台-传染病网络直报系统的报卡模式。为了解现阶段基于区域平台自动交换的传染病报告现状,为进一步完善四川省法定传染病信息报告自动交换工作提供依据,特开展此次调查。
采用分层随机抽样方法,在四川省21个市(州)每个市(州)分别抽取1~2家市(州)级、县(区)二级及以上医疗机构,有省级医疗机构的市州调查对象增加1家省级二级及以上医疗机构,本次调查共抽取68家医疗机构。
采用面对面访谈及现场调查方式进行预调查。通过查阅文献和专家咨询,结合预调查结果,制定调查问卷,现场通过问卷星对医疗机构防保科医生进行问卷的发放、填写和收集。调查内容包括本院基础信息系统(HIS、LIS、PACS)建设和使用情况,系统报告管理、预警等功能的实现,系统维护、系统使用培训情况、使用感受及存在问题等。调查回收问卷68份,有效问卷68份,有效率100.00%。
基础信息系统的建设使用、系统报告管理和预警等功能是自动交换功能实现的基础[4]。通过计算基础信息系统的建设率和权限开放率了解系统建设和使用情况;依据《全国传染病信息报告管理工作技术指南(2016年版)》,报告管理功能包括传染病报告卡的自动生成、传染病报告卡管理和信息统计查询功能;预警功能包括是否能够预警、预警信息来源、预警内容等,以此评价预警是否全面、可靠。
通过查阅2023年7—12月传染病直报系统与省交换平台数据,计算调查单位粗交换成功率、交换成功率。参考既往研究[5-6],本文将交换成功率是否≥95%作为分组标准进行两组相关因素的比较,≥95%被认为交换质量相对较好。实现自动交换时间间隔为医疗机构正式实现自动交换到2023年12月31日的时间间隔。
采用R 4.2.2软件进行t检验、卡方和趋势卡方检验,R ggpubr软件包用于spearman相关分析,P<0.05为差异有统计学意义。
2023年7—12月68家医疗机构省交换平台交换卡片总数146 922,成功交换数140 859张,粗交换成功率为95.87%;传染病网络直报系统报卡数151 995张,共11 136张卡片未通过交换平台上报传染病网络直报系统,交换成功率为92.67%。与其他级别医疗机构比较,市级粗交换成功率、交换成功率、实现自动交换时间间隔均较高,差异有统计学意义。见表1
68家医疗机构中,交换成功率95%及以上的有33家,占比48.53%。粗交换成功率有35家达到95%及以上,占比51.47%,其中2家达100.00%,交换不成功的主要原因为卡片填写存在逻辑错误或不符合填报规则、系统错误。
将交换成功率按是否大于95%进行分组比较,两组实现自动交换时间间隔和粗交换成功率均有所不同,差异有统计学意义,见表2。Spearman相关分析结果显示交换成功率与实现自动交换时间间隔(r=0.44,P<0.001)、粗交换成功率(r=0.51,P<0.001)均呈正相关。
68家医疗机构中,HIS门诊、HIS住院、LIS和PACS系统的建设率分别为68家100.00%(68/68),97.06%(66/68),95.59%(65/68),92.65%(63/68),以上系统均有的共61家(89.71%)医疗机构。与HIS系统相比,LIS和PACS系统功能权限(浏览、查询和导出功能均有)对防保科医生开放比例低,权限开放率有下降趋势,差异有统计学意义。HIS、LIS、PACS系统浏览、查询和导出权限均有的医疗机构仅22家(32.35%),见表3
68家医疗机构中,具有传报卡管理和信息统计查询功能的比例均达到80%以上,能自动生成传报卡的机构占比为77.94%,见表4。53家能自动生成传报卡的医疗机构生成传报卡过程中能自动抓取填写的信息以“报卡信息”和“病人基本信息”为主,能够完全、大部分抓取“病人发病及诊断信息”和“附卡相关信息”的机构占比合计均不足60%。各类信息完全实现自动抓取并填写的机构占比差异有统计学意义(χ2=19.695,P<0.001)。见表5
50家(73.53%)医疗机构实现了传报卡的自动预警,预警主要基于门诊日志、住院日志、实验室检验数据生成,能够实现的机构分别为70.59%、69.12%、67.65%,实现基于影像检验和病案数据进行预警的机构占比分别为54.41%和48.53%。预警后强制报卡(规定时间内不报卡或排除,不能进行其他操作)的机构数为17家,占比25.00%。
系统预警功能中,63.24%的医疗机构可以对院内重卡进行预警,其次是迟报卡(55.88%)和甲类及甲管传染病(52.94%)。能对罕见病、新发病、聚集性疫情预警的医疗机构占比不足50%。与其他级别医疗机构各预警功能相比,市级能进行甲类及甲管传染病预警的占比较高,差异有统计学意义。见表6
59家(86.76%)医疗机构传染病自动交换相关系统发现问题,能及时得到服务提供方的及时维护、完善。60家(88.24%)医疗机构现有硬件设施环境(计算机、网络设备等)能满足传染病自动交换工作。59家(86.76%)医疗机构防保科医生接受过传染病自动交换相关系统使用培训。实现自动交换后68家(100%)医疗机构均仍在持续开展传统传染病报告自查工作。自动交换前后对比,传染病报告工作量减轻的有60家(88.24%)。
传染病报告自动交换的实现,为其他公共卫生监测数据自动交换及多来源数据互联互通提供了良好基础,是医防协同的重要体现和实践[7]。与传统的传染病报卡方式相比,自动交换优化了传染病报告流程,临床医生主要通过传报卡自动生成和填报功能进行报卡,防保科或公共卫生科医生无需进行重复录入,只需对卡片进行审核后一键上报[5],很大程度上减轻了医生的报卡工作量,与其他研究结果一致[8]
四川省二级及以上医疗机构基本实现传染病自动交换后的半年,被调查医疗机构交换成功率和粗交换成功率分别达到92.67%和95.87%,大部分医疗机构在使用自动交换系统进行传染病报告且整体粗交换成功率较高。但机构间交换成功率的差异较大,与浙江省研究结果一致[4]。结果显示,与其他级别医疗机构比较,市级医疗机构交换成功率较高,可能与市级实现自动交换的时间较早,系统功能较为完善,粗交换成功率较高有关。建议医疗机构,尤其是县区级医疗机构,根据传染病报告管理规范、接口技术文档的调整,及时更新自动交换系统,缩短系统使用磨合期,进一步提高传染病交换成功率。
传染病自动交换功能依赖于医疗机构基本信息系统传染病报告管理功能的建立[9],医院HIS、LIS、PACS系统的建设使用、传报卡自动生成和管理、信息统计和预警功能是自动交换的基础[4,10]。本次调查中医疗机构基本信息系统建设率较高,但传染病报告管理功能还不完善,各医疗机构传染病信息化建设不均衡,传染病报告模块功能开发质量参差不齐。传染病从诊断报告、审核订正,涉及到的环节细节较多[11],防保科医生系统权限不够[12]、自动生成抓取信息的不完全、预警范围单一、预警后未强制报卡[13]、对传染病异常信息不能及时预警,均可能造成错报、漏报、迟报,在一定程度上影响了自动交换质量和效率,与其他研究结果一致[14-15]。建议医疗机构进一步梳理传染病自动交换流程,增加信息化经费投入,完善基础信息系统适应性改造,建设相关缺失功能。
本次调查的68家医疗机构仍在持续开展传染病报告自查工作,自动交换系统还不能完全替代手工报卡。系统的后期维护质量影响和制约着传染病自动交换质量[6],医疗机构在自动交换相关系统使用初期应加强对医生的培训,使其尽快熟悉和掌握自动交换流程和操作方法,完善问题反馈机制,及时做好系统后期完善维护,切实提高自动交换质量。
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2024年第51卷第16期
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doi: 10.20043/j.cnki.MPM.202404309
  • 接收时间:2024-04-18
  • 首发时间:2026-03-18
  • 出版时间:2024-08-25
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  • 收稿日期:2024-04-18
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    四川省疾病预防控制中心,四川 成都 610041

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genus
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species
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Percentage of total
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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