CAJ | 학술논문

目的了解全国疾病监测系统(DSPs)死亡病例报告工作的漏报情况及其漏报特征.方法采用多阶段随机整群抽样的方法,在DSPs的161个监测点各抽取6个行政村(居委会),收集其2006-2008年常住人口资料,开展死亡病例漏报调查,覆盖人口6 422 667名,分年龄、性别和地区对漏报率进行估计,并对漏报率调整前后的死亡率进行比较.结果全国总粗死亡漏报率为16.68％ (6271/37 603),经加权调整后,漏报率为17.44％,城市略低于农村,分别为16.08％与18.14％ (P ＜0.01)；中部与西部高于东部,分别为19.27％、18.15％和15.46％ (P＜0.01).0～4岁儿童漏报率远高于5岁以上年龄组,分别为34.95％、16.90％ (P ＜0.01)；其中0～4岁年龄组性别差异较大,女性为39.36％,男性为31.93％.死亡率经漏报调整后,全国男性的死亡率由6.38‰调整到7.74‰,女性由4.66‰调整到5.64‰；中部地区男性死亡率调整前后分别为6.49‰与8.00‰,女性调整前后分别为4.59‰与5.73‰.0～4岁儿童死亡率男性调整前后分别为2.48‰与3.64‰,女性调整前后分别为1.98‰与3.27‰;其中,城市儿童死亡率调整前男性死亡率高于女性,分别为1.76‰与1.39‰,调整后儿童女性死亡率高于男性,分别为2.41‰与2.26‰.5岁以上男性死亡率经漏报调整后由6.60‰调整到7.96‰,女性由4.80‰调整到5.77‰.结论全国疾病监测系统死亡漏报率存在地区和年龄差别,0～4岁儿童的死亡漏报率存在性别差别.
목적 료해전국질병감측계통(DSPs)사망병례보고공작적루보정황급기루보특정.방법 채용다계단수궤정군추양적방법,재DSPs적161개감측점각추취6개행정촌(거위회),수집기2006-2008년상주인구자료,개전사망병례루보조사,복개인구6 422 667명,분년령、성별화지구대루보솔진행고계,병대루보솔조정전후적사망솔진행비교.결과 전국총조사망루보솔위16.68％ (6271/37 603),경가권조정후,루보솔위17.44％,성시략저우농촌,분별위16.08％여18.14％ (P ＜0.01)；중부여서부고우동부,분별위19.27％、18.15％화15.46％ (P＜0.01).0～4세인동루보솔원고우5세이상년령조,분별위34.95％、16.90％ (P ＜0.01)；기중0～4세년령조성별차이교대,녀성위39.36％,남성위31.93％.사망솔경루보조정후,전국남성적사망솔유6.38‰조정도7.74‰,녀성유4.66‰조정도5.64‰；중부지구남성사망솔조정전후분별위6.49‰여8.00‰,녀성조정전후분별위4.59‰여5.73‰.0～4세인동사망솔남성조정전후분별위2.48‰여3.64‰,녀성조정전후분별위1.98‰여3.27‰;기중,성시인동사망솔조정전남성사망솔고우녀성,분별위1.76‰여1.39‰,조정후인동녀성사망솔고우남성,분별위2.41‰여2.26‰.5세이상남성사망솔경루보조정후유6.60‰조정도7.96‰,녀성유4.80‰조정도5.77‰.결론 전국질병감측계통사망루보솔존재지구화년령차별,0～4세인동적사망루보솔존재성별차별.
Objective To describe the status and characteristics of under-reporting of death cases within national disease surveillance system(DSPs).Methods Six villages (communities) were selected in each of the 161 counties of DSPs by multi-stage random cluster sampling methods,the information of resident from 2006 to 2008 was collected,and a survey of the under-reporting deaths cases was carried out which covered 6 422 667 people in all.The under-reporting rate was estimated by ages,genders and regions.The mortality was compared before and after the adjustment of the under-reporting rate.Results The total crude rate of under-reporting of whole nation was 16.68％ (6271/37 603),and after the adjustment by weight the rate was 17.44％ ; the under-reporting rate of urban areas was a bit lower than rural areas,which were 16.08％ and 18.14％ respectively( P ＜0.01 ); the under-reporting rate of middle and west regions were higher than the east,which were 19.27％,18.15％ and 15.46％ respectively ( P ＜ 0.01 ).The underreporting rate of children of under-five years old was much higher than that of people of five and above-five years old,which were 34.95％ and 16.90％ respectively( P ＜ 0.01 ).The gender difference was especially obvious in age group 0 - 4,for women 39.36％ while 31.93％ for men.After adjusted by under-reporting rate,the mortality rate of male rised from 6.38‰ to 7.74‰ and for female rised from 4.66‰ to 5.64‰.In the middle region,the mortality rate of male rised from 6.49‰ to 8.00‰ and for female rised from 4.59‰ to 5.73‰ after the adjustment.And the mortality rate of male in age group 0 - 4 rised from 2.48‰ to 3.64‰ and for female rised from 1.98‰ to 3.27‰.Of which in urban area,the mortality rate of male was much higher than female before the adjustment,which were 1.76‰ and 1.39‰ respectively; however,the mortality rate of male was a bit lower than female after the adjustment,which were 2.26‰ and 2.41 ‰ respectively.The mortality in male of five and above-five rised from 6.60‰ to 7.69‰ after the adjustment while in female rised from 4.80‰ to 5.77‰.Conclusion There are regional and age-group differences of the under-reporting rate of the National Disease Surveillance System.The gender differences mainly shows in age 0 -4.