Adjustment and representativeness evaluation of national disease surveillance points system

Objective To adjust the national disease surveillance points system (DSPs) and evaluate its representativeness. Methods The census data in 2000 and nationwide county survey data were used to evaluate the representativeness of national DSPs adjusted in 1989. U test was used to compare the GDP per capita, the proportion of non-agricultural population, the illiteracy rate of the people aged over 15, the proportion of 0-14 years old people and the proportion of 65 years old people in total population, mortality rate, birth rate in the areas in DSPs with corresponding area in the country, and the DSPs was adjusted according to the evaluation results. The counties in the country were divided into 54 strata based on the indicators of geographic characteristics, economics and population. The actual county number in each stratum was used to determine the theoretical county number in each stratum in DSPs, and then the number and distribution of the surveillance points in current DSPs were adjusted. The representative evaluation was conducted again after the system adjustment. Results One or more indicators were significant different between the rural and urban areas, eastern central and western urban areas, as well as the western rural areas in national DSPs and the corresponding areas in the country, Adjusted national DSPs includes 161 counties/districts (63 districts and 98 counties). The representative evaluation results indicated that there was no significant difference of on the indicators between urban areas, rural areas, eastern central and western urban areas and rural areas in national DSPs and the corresponding areas in the country except the total indicator of urban and rural area. Conclusion Adjusted national DSPs has good representativeness both in urban and rural areas. The estimation of country level should correct the proportions of urban area and rural to reflect the national level.