通讯作者: 阿克忠, akz1307@126.com

DOI：10.12201/bmr.202501.00057

• 摘要：摘要 目的:对2021年青海省部分医疗机构在国家法定传染病报告信息管理系统报告的3368例乙型病毒性肝炎（简称“乙肝”）住院病例诊断信息进行复核，分析其报告一致性和影响因素。方法: 研究采用典型调查法，在2022年7月至2023年4月，选取青海省32家医疗机构报告的3368例乙肝住院病例。通过复核病例诊断信息，结合Kappa一致性检验评价报告分类与复核分类的一致性，并对一致性影响因素进行单因素与多因素分析。结果: 对3368例NNDRS报告的乙肝住院病例复核,急性、慢性、未分类报告分类与复核分类一致性较差（Kappa＜0.40）；急慢性复核一致性较差（Kappa＜0.40）。影响复核一致性的主要因素包括医疗机构级别、患者性别、职业、既往史及初次发病诊断单位。省级医疗机构报告的一致性较高，男性病例和牧民病例的一致性优于女性病例及其他职业。结论: 2021年青海省医疗机构乙肝病例诊断报告一致性较低，存在分类不准确和重复报告问题。建议加强医疗机构培训与监督，规范填写“附卡”信息，推广抗-HBc IgM检测以改善急慢性乙肝的分类诊断，全面提升乙肝病例诊断与报告的准确性。

   

  Abstract: Abstract Objective: To review the diagnostic information of 3,368 viral hepatitis B (Hepatitis B) inpatient cases reported by some healthcare institutions in Qinghai Province in the National Statutory Infectious Disease Reporting Information Management System in 2021, and to analyse the consistency of their reports and the factors affecting them. Methods: From July 2022 to April 2023, 3368 hepatitis B inpatient cases reported by 32 medical institutions in Qinghai Province were selected for the study using a typical survey method. The consistency between the reported classification and the reviewed classification was evaluated by reviewing the diagnostic information of the cases, combined with the Kappa consistency test, and the consistency-influencing factors were analysed in a univariate and multivariate manner. Results: In 3368 NNDRS-reported hepatitis B inpatient cases, the consistency between acute, chronic, and unclassified reporting classifications and review classifications was poor (Kappa < 0.40); the consistency between acute and chronic review was poor (Kappa < 0.40). The main factors affecting the consistency of review included the level of the medical institution, the patients gender, occupation, past history, and the unit of diagnosis of the initial onset of illness. Provincial medical institutions reported higher consistency, and male cases and herder cases had better consistency than female cases and other occupations. Conclusion: The consistency of diagnosis and reporting of hepatitis B cases in healthcare institutions in Qinghai province in 2021 was low, with problems of inaccurate classification and duplicate reporting. It is recommended to strengthen the training and supervision of healthcare institutions, standardise the filling of ‘attached card’ information, and promote the anti-HBc IgM test to improve the classification and diagnosis of acute and chronic hepatitis B, so as to comprehensively improve the accuracy of the diagnosis and reporting of hepatitis B cases.

  提交时间：2025-01-20

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• 序号	提交日期	编号	操作
  1	2024-11-21	bmr.202501.00057V1	下载

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