大数据与人工智能时代背景下医院感染监测预警变量与效能调查与评估
Investigation of health care-associated infections surveillance and early-warning variables and assessment of their efficiencies in the era of big data and artificial intelligence
-
摘要: 目的 调查某地区二级及以上医疗机构医院感染监测数据质量现状,分析其在大数据与人工智能技术应用中的预警变量与效能,为构建智能化、精准化的医院感染监测预警体系提供数据支持与改进方向。方法 采用问卷调查法及现场核查法,对2023年某地区医疗机构医院感染病例监测现状进行研究,评估其信息化水平、数据质量、预警效能及人力资源投入等情况。结果 本研究提示89.19%的医院已实现信息化监测,其中三级医院信息化监测占比达96.55%,高于二级医院水平(P=0.026)。监测效能方面,每150张床位每天配置专职监测人员数量中位数为0.65(0.41,1.23)人,二级医院配置人员人数明显高于三级医院(P=0.045)。三级和二级医院监测耗时相当,即每150张床位每人每日消耗0.30 h,每150床位每日预警病例中位数为3.70例。数据质量方面,94.12%的医院开展不同程度的数据质量评估,62.16%的医院漏报率控制在5%以内; 35.14%的医院自评准确性在90%~95%,32.43%在95%以上,三级医院数据及时性优于二级医院(P=0.031)。结论 大数据与人工智能时代,智能化监测预警可以大幅提升监测预警效能,但也对数据质量提出更高要求。当前医院感染监测信息化普及率虽高,但为推动其向智能化、精准化迈进,避免因数据质量不足产生错误预警,需要更多的关注监测数据的质量,提升预警效能。Abstract: OBJECTIVE To investigate the current status of quality of health care-associated infections (HAIs) surveillance data in secondary or above medical institutions, analyze the early-warning variables in application of big data and artificial intelligence, and observe the efficiencies so as to provide supporting data for construction of intelligentized and precise HAIs surveillance and early-warning system and guidance for improvement. METHODS By mean of questionnaire survey and onsite verification, the current status of surveillance of HAIs cases in the medical institutions of 2023 was studied. The informatization level, quality of data, early-warning efficiency and human resource investment were evaluated. RESULTS The research showed that 89.19% of the hospitals have achieved the information-based surveillance, the percentage of the tertiary hospitals with the information-based surveillance was 96.55%, higher than that of the secondary hospitals(P=0.026). Regarding to the efficiency of surveillance, the median number of full-time surveillance personnel per 150 beds per day was 0.65 (IQR: 0.41~1.23), and the number of the personnel was remarkably larger in the secondary hospitals than in the tertiary hospitals (P=0.045). The time consumed for surveillance was approximately same in the tertiary hospitals and the secondary hospitals, that was 0.3 hour per 150 beds per person per day, and the median number of early-warning cases was 3.70 cases per 150 beds per day. With the respect to the quality of data, 94.12% of the hospitals achieved various degree of evaluation of data quality, 62.16% of the hospitals controlled the missing report rate within 5%; 35.14% of the hospitals had the accuracy of self-assessment ranging between 90% and 95%, with higher than 95% in 32.43% of the hospitals; the timeliness of data of the tertiary hospitals was superior to that of the secondary hospitals (P=0.031). CONCLUSIONS The intelligent surveillance and early-warning system can substantially raise the early warning efficiency in the era of big data and artificial intelligence, but it imposes higher demands for the quality of data. Although the popularizing rate of informatization of HAIs surveillance is high, it is necessary to attach more importance to the quality of data and raise the early-warning efficiency so as to push forward the intelligentized and precise informatization of HAIs surveillance and prevent the false early warning due to the poor quality of data.
下载: