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台北地區醫院傳染病報告現況之評估

Evaluation of the Reporting System for Communicable Diseases in Taipei, 1981-1983

Abstracts


爲瞭解台北地區現行傳染病報告通報單的完整性、代表性以及時效性問題,本研究評估民國70年至72年間台北市五家准一級以上教學醫院有關傷寒副傷寒、小兒麻痺、百日咳、志賀氏痢疾等的通報情形,並調查183名住院醫師對傳染病報告的實際行爲而提示改進報告系統之建議。研究結果發現:雖然疾病的平均報告率只有42%,但是由報告病例所得之性別、年齡、發病地點的分布,與由住院病例所得之分布相近;但是由於流行初期的病例往往未被報告,以至無法正確而及時掌握流行的時間變化。時效性方面,爲要確定病例而過於依賴實驗診斷,以致影響疾病報告的時間。根據評估的結果及對醫師的問卷調查,本研究建議除了按疾病特性增加利用醫院檢驗室爲報告的來源,以及加強通報單接報後的追跺調查外,並應有系統定期性地評估各項污染病報告的績效,以確實瞭解報告的內容、方式是否有效被執行。

Parallel abstracts


In order to evaluate the completeness, accuracy and timeliness of the reports of communicable diseases, we have interviewed 183 resident physicians from five teaching hospitals in Taipei, and reviewed 194 discharge records of typhoid and paratyphoid fever, poliomyelitis, whooping cough and shigellosis during 1981-1983 from these hospitals. Though the percentage of these cases reported averaged 427, the reports were useful as a guide for disease coutrol. But these reports should be improved to be able to recognize the state of the epidemic. Delays in reporting is a serious problem, and more than 60% of the reported cases were not reported within 24 hours as the law required. We recommend following procedures to improve the effectiveness of the reporting system: (1) Feedback reports should be sent to the reporting clinicians, (2) Reports of positive cases could be directly sent from the hospital laboratories, (3) Periodical evaluation of the reporting system should be performed at least once a year.

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