The University of North Carolina at Chapel Hill, Gillings School of Global Public Health, North Carolina Institute for Public Health, Chapel Hill, NC ; Current affiliation: Durham County Department of Public Health, Durham, NC.
Public Health Rep. 2013 Sep-Oct;128(5):393-8. doi: 10.1177/003335491312800510.
Electronic laboratory reporting (ELR) reduces the time between communicable disease diagnosis and case reporting to local health departments (LHDs). However, it also imposes burdens on public health agencies, such as increases in the number of unique and duplicate case reports. We assessed how ELR affects the timeliness and accuracy of case report processing within public health agencies.
Using data from May-August 2010 and January-March 2012, we assessed timeliness by calculating the time between receiving a case at the LHD and reporting the case to the state (first stage of reporting) and between submitting the report to the state and submitting it to the Centers for Disease Control and Prevention (second stage of reporting). We assessed accuracy by calculating the proportion of cases returned to the LHD for changes or additional information. We compared timeliness and accuracy for ELR and non-ELR cases.
ELR was associated with decreases in case processing time (median = 40 days for ELR cases vs. 52 days for non-ELR cases in 2010; median = 20 days for ELR cases vs. 25 days for non-ELR cases in 2012; both p<0.001). ELR also allowed time to reduce the backlog of unreported cases. Finally, ELR was associated with higher case reporting accuracy (in 2010, 2% of ELR case reports vs. 8% of non-ELR case reports were returned; in 2012, 2% of ELR case reports vs. 6% of non-ELR case reports were returned; both p<0.001).
The overall impact of increased ELR is more efficient case processing at both local and state levels.
电子实验室报告(ELR)减少了传染病诊断与向地方卫生部门(LHD)报告之间的时间间隔。然而,它也给公共卫生机构带来了负担,例如增加了独特和重复病例报告的数量。我们评估了 ELR 如何影响公共卫生机构内病例报告处理的及时性和准确性。
使用 2010 年 5 月至 8 月和 2012 年 1 月至 3 月的数据,我们通过计算从 LHD 接收病例到向州报告病例(报告的第一阶段)以及从向州提交报告到向疾病控制和预防中心提交报告(报告的第二阶段)之间的时间来评估及时性。我们通过计算返回给 LHD 以进行更改或补充信息的病例比例来评估准确性。我们比较了 ELR 和非 ELR 病例的及时性和准确性。
ELR 与病例处理时间的缩短有关(2010 年 ELR 病例的中位数为 40 天,而非 ELR 病例为 52 天;2012 年 ELR 病例的中位数为 20 天,而非 ELR 病例为 25 天;两者均 p<0.001)。ELR 还允许有时间减少未报告病例的积压。最后,ELR 与更高的病例报告准确性相关(2010 年,ELR 病例报告的 2%,而非 ELR 病例报告的 8%被退回;2012 年,ELR 病例报告的 2%,而非 ELR 病例报告的 6%被退回;两者均 p<0.001)。
ELR 增加的总体影响是在地方和州一级提高了病例处理的效率。