Hansen Nanna, Cowan Susan, Christensen Peer Brehm, Weis Nina
Infektionsmedicinsk Afdeling, Hvidovre Hospital,DK-2650 Hvidovre.
Ugeskr Laeger. 2008 Apr 28;170(18):1567-70.
It became mandatory to report cases of chronic hepatitis B and C in Denmark in May 2002. The "treating doctor" is obliged to make the report. The purpose of this study is to find out how many patients with chronic hepatitis B or C who are monitored in the Danish health care system are reported to the State Serum Institute (SSI) and to find out who makes the report and from these numbers to estimate the total number of patients in Denmark with chronic hepatitis B and C.
Patients with chronic hepatitis B or C who were reported to the SSI before June 20th 2006 were cross-referenced with patients included in the Danish Database of Hepatitis B and C (DANHEP) on the basis of their social security number.
The study found that only 50% of patients monitored at Danish hospitals with chronic hepatitis B or C are registered with the SSI. Respectively 47% and 38% of these were registered by their general practitioner, a few percent by a doctor whose place of employment is not registered, and the rest by doctors working at hospitals.
This study demonstrates that the reporting of patients with chronic hepatitis B and C in Denmark is considerably inadequate. It is important that general practitioners as well as doctors working at hospitals are aware of their duty to report these diseases. An optimal reporting rate could be achieved by making it mandatory to notify the laboratory diagnosis of chronic hepatitis B and C as well as establishing an electronic reporting system, where data from laboratories are cross-referenced with clinical and epidemiological data.
2002年5月起,丹麦规定必须报告慢性乙型和丙型肝炎病例。“主治医生”有义务进行报告。本研究的目的是查明在丹麦医疗保健系统中接受监测的慢性乙型或丙型肝炎患者有多少被报告给了国家血清研究所(SSI),并查明报告者是谁,进而根据这些数字估算丹麦慢性乙型和丙型肝炎患者的总数。
将2006年6月20日前报告给SSI的慢性乙型或丙型肝炎患者,根据其社会保险号与丹麦乙型和丙型肝炎数据库(DANHEP)中收录的患者进行交叉比对。
研究发现,在丹麦医院接受慢性乙型或丙型肝炎监测的患者中,只有50%在SSI进行了登记。其中,分别有47%和38%是由其全科医生登记的,有百分之几是由工作单位未登记的医生登记的,其余的是由医院医生登记的。
本研究表明,丹麦慢性乙型和丙型肝炎患者的报告情况严重不足。全科医生以及医院医生必须意识到报告这些疾病的责任。通过强制要求报告慢性乙型和丙型肝炎的实验室诊断结果以及建立电子报告系统,将实验室数据与临床和流行病学数据进行交叉比对,可实现最佳报告率。