Quality of Dengue Hemorrhagic Fever Patients Report in Government Hospitals, Yasothon Province

Abstract

The study design was cross‐sectional descriptive study. The objective of this study was
to assess the quality of Dengue Hemorrhagic Fever (DHF) patients report in
Government Hospitals, Yasothon Province of completeness, accuracy and timeliness.
Furthermore, it was to study about the sensitivity, specificity and positive‐negative
predictive value of DHF patients report in 506/507 reports system and in DHF
diagnosis of physician with definite of presumptive diagnosis DHF compare to the
patient reports in the hospital database. The data was collected from hospital
database in 9 government hospitals, Yasothon Province between 1 January 2010 to
31 December 2010. There were 7,125 patients from hospital summary records
(ICD‐10: A90, A91, B349 and R509). DHF was selected by clinical and laboratory.
Following the clinical diagnosis and laboratory results, there were 890 cases of DHF
and 732 (82.2%) cases were collected for data in this study. The data were present
as frequency, percentage, minimum‐maximum, mean and standard deviation.
The results showed that completeness of the reported patients was 30.5 % (223
cases). The completeness of the variables was complete in all patients. The variable
at gender was the accuracy in all patients. In addition, the variables that must be
lower than the standard criteria as final diagnosis, date define and date sick were
71.3%, 70.9% and 43.0% respectively. For the timeliness when the hospital
facilities must be reported to the provincial Epidemiological Center within 1 day
after the finding of the patients and the physician concluded that the suspected DHF.
It was found that timeliness 46.6% (104 cases). The sensitivity and specificity of the
reporting system 506/507 were 30.6% and 97.9%.The positive and negative
predictive values were 67.3% and 90.8%. The sensitivity, specificity and positive
and negative predictive values of clinical diagnosis were compared with the
definition of initial diagnosis. Dengue was diagnosed when the physician found that
DF sensitivity was 23.7%. The specificity was 44.4 %. The positive and negative
predictive value were 29.0% and 37.8% respectively. In addition, the clinical
diagnosis of DHF was showed the sensitivity at 72.9%. The specificity was 80.2%.
The positive and negative predictive value were 77.9% and 75.6% respectively.
The results of this study showed that the quality of reported dengue patients in
government hospitals was lower than standard criteria especially completeness of
the patient reports and timeliness. There for, the provincial Epidemiological Center
must expedite, control and monitor the quality of report to the standards of
epidemiological surveillance. The diagnosis of physician diagnosis using the right
definition of especially diagnosis of dengue to be DF. Then, there must be the
continuous for the physician cause of definition DHF by diagnosed.