关键词: 结核,肺, 病人转诊, 漏报, 北京市

Abstract:

Objective: To analyze the under-reporting situation of network infectious disease reports (hereinafter referred to as “network reporting”) of pulmonary tuberculosis patients before registration and management in the tuberculosis prevention and control (referred to as “tuberculosis prevention”) institutions in Xicheng District, Beijing, and to provide a scientific basis for further improvement of patient detection. Methods: The data was from the “Tuberculosis Information Management System”, a subsystem of the “China Information System for Disease Control and Prevention”, and the medical records of the outpatient department of Xicheng tuberculosis prevention institution from 2018 to 2023. A total of 1233 patients who needed network reporting before arrival were divided into 693 cases of symptom-based consultations and 540 cases of health check-ups according to the source of the patients. The under-reporting situation before arrival was analyzed, and the imaging and disease conditions of the patients at the time of arrival were comparatively analyzed. Results: Among the 1233 patients, 887 were reported before arrival, and 346 were not reported. There were 135 under-reported cases among the symptom-based consultation patients, with an under-reporting rate of 19.48% (135/693), and 211 under-reported cases among the health check-up patients, with an under-reporting rate of 39.07% (211/540). The under-reporting rate of symptom-based consultation patients was lower than that of health check-up patients, and the difference was statistically significant (χ²=57.719, P<0.001). Comparing the image and symptoms of patients at the time of arrival for symptom-based consultations and health check-ups, the proportions were as follows: the lesion involved 1-3 sites, 76.91% (533/693) and 90.37% (488/540); cavities, 38.67% (268/693) and 22.22% (120/540); cough and expectoration, 72.15% (500/693) and 18.15% (98/540); hemoptysis, 12.84% (89/693) and 0.93% (5/540); other symptoms, 51.08% (354/693) and 9.26% (50/540). All the differences were statistically significant (χ²=38.611, 38.084, 354.351, 61.201, 240.982, all Ps<0.001). Conclusion: The under-reporting rate before arrival of health check-up patients in the tuberculosis prevention institutions in Xicheng District, Beijing was significantly higher than that of symptom-based consultation patients. However, the condition of symptom-based consultation patients was more serious. It suggests that it is necessary to further improve the existing supervision and inspection methods of tuberculosis prevention institutions and to establish a network reporting mechanism for pulmonary tuberculosis in independent physical examination institutions to further improve the detection of pulmonary tuberculosis patients.

Key words: Tuberculosis,pulmonary, Patient referral, Under-reporting, Beijing City