Elcock M, Simon T, Gilbert B P, Copello A G, Kelzer P J
AIDS Program, San Mateo County Department of Health Services, CA.
Am J Public Health. 1993 Jul;83(7):1002-5. doi: 10.2105/ajph.83.7.1002.
Health departments that use passive surveillance alone cannot be sure of the level of complete and accurate reporting of acquired immunodeficiency syndrome (AIDS) cases. We sought to develop a model of active AIDS case reporting using limited county resources.
A validation study of AIDS case reporting using discharge diagnosis codes was undertaken to assess underreporting. Hospital-specific protocols for active surveillance were developed.
The validation study revealed that 24% of AIDS cases in all hospitals were not reported through passive surveillance in 1990. In the first 3 months of 1991, active surveillance identified nine unreported cases (69% of the total cases reported) in one hospital. These underreporting estimates far exceed the 15% national underreporting rate estimated by the Centers for Disease Control.
A method of hospital-based case finding was developed and serves as the model for implementing an ongoing program of active surveillance needed to ensure complete, accurate, and timely reporting of diagnosed AIDS cases. Application of this model may be helpful in attempts to minimize underreporting.
仅采用被动监测的卫生部门无法确定获得性免疫缺陷综合征（艾滋病）病例完整且准确的报告水平。我们试图利用有限的县级资源开发一种主动报告艾滋病病例的模式。
开展一项利用出院诊断编码进行艾滋病病例报告的验证研究，以评估漏报情况。制定了针对各医院的主动监测方案。
验证研究显示，1990年所有医院中24%的艾滋病病例未通过被动监测报告。1991年的前3个月，主动监测在一家医院发现了9例未报告病例（占报告病例总数的69%）。这些漏报估计数远远超过疾病控制中心估计的15%的全国漏报率。
开发了一种基于医院的病例发现方法，作为实施确保完整、准确和及时报告确诊艾滋病病例所需的持续主动监测计划的模式。应用该模式可能有助于尽量减少漏报情况。
