Fill Mary-Margaret A, Murphree Rendi, Pettit April C
Departments of Internal Medicine and Pediatrics (Dr Fill) and Division of Infectious Diseases, Department of Internal Medicine (Dr Pettit), Vanderbilt University Medical Center, Nashville, Tennessee; Tennessee Department of Health, Nashville, Tennessee (Dr Murphree); and Career Epidemiology Field Officer Program, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Murphree).
J Public Health Manag Pract. 2017 Nov/Dec;23(6):581-588. doi: 10.1097/PHH.0000000000000492.
In the United States, state laws require health care providers to report specific diseases and events to public health authorities, a fundamental facet of disease surveillance. However, reporting by providers is often inconsistent, infrequent, and delayed.
To examine knowledge, attitudes, and practices regarding provider disease reporting and to understand current barriers to provider disease reporting.
A cross-sectional study was conducted via an anonymous, standardized electronic survey.
The survey was conducted at Vanderbilt University Medical Center, a large, tertiary academic medical center in Nashville, Tennessee.
Health care providers in 4 specialties (internal medicine, pediatrics, obstetrics-gynecology, and emergency medicine).
MAIN OUTCOME MEASURE(S): Knowledge of and attitudes regarding provider reporting of diseases to public health authorities in Tennessee.
The majority of providers acknowledged they cared for patients with reportable diseases (362/435, 83.2%) and believed that it was their responsibility to report to public health authorities (429/436, 98.4%); however, less than half had ever reported a case (206/436, 47.2%). The median percent correct on the knowledge assessment of Tennessee reportable diseases and conditions was 81.3% (interquartile range = 68.8-87.5). Providers cited a lack of knowledge of which diseases are reportable (186/429, 43.3%) and the logistics of reporting (153/429, 35.7%) as the primary barriers for compliance.
Most providers acknowledged they cared for patients with reportable diseases and believed they had an obligation to report to public health authorities. However, a lack of knowledge about reporting was frequently described as a limitation to report effectively. Many knowledge deficits were significantly greater among residents than other providers.The policy and practice implications of these findings include a demonstrated need for education of providers about disease reporting as well as development of more convenient reporting mechanisms. Fundamental knowledge of reportable disease requirements and procedures is critical for participation in the broader public health system.
在美国,州法律要求医疗保健提供者向公共卫生当局报告特定疾病和事件,这是疾病监测的一个基本方面。然而,提供者的报告往往不一致、不频繁且延迟。
研究医疗保健提供者关于疾病报告的知识、态度和做法,并了解当前医疗保健提供者疾病报告的障碍。
通过匿名、标准化的电子调查进行横断面研究。
该调查在田纳西州纳什维尔的大型三级学术医疗中心范德比尔特大学医学中心进行。
4个专业(内科、儿科、妇产科和急诊医学)的医疗保健提供者。
田纳西州医疗保健提供者向公共卫生当局报告疾病的知识和态度。
大多数提供者承认他们照顾患有应报告疾病的患者(362/435,83.2%),并认为向公共卫生当局报告是他们的责任(429/436,98.4%);然而,不到一半的人曾报告过病例(206/436,47.2%)。田纳西州应报告疾病和状况的知识评估中正确答案的中位数百分比为81.3%(四分位间距 = 68.8 - 87.5)。提供者指出,对应报告疾病的知识缺乏(186/429,43.3%)和报告的后勤问题(153/429,35.7%)是合规的主要障碍。
大多数提供者承认他们照顾患有应报告疾病的患者,并认为他们有义务向公共卫生当局报告。然而,对报告缺乏了解经常被描述为有效报告的一个限制。住院医师的许多知识缺陷明显大于其他提供者。这些发现的政策和实践意义包括表明需要对提供者进行疾病报告教育以及开发更便捷的报告机制。对应报告疾病要求和程序的基本知识对于参与更广泛的公共卫生系统至关重要。