背景：完整、正確與及時的疫情通報監視是傳染病防治的重要關鍵。重整後的結核病防治體系也非常重視結核病的通報與登記，近幾年來也有許多改革措施，但是台灣至今仍無有系統的研究確實推估結核病「未通報」與「延遲通報」的數目為何？相關影響因素為何？ 目的：本研究首先透過健保申報資料庫與結核病通報登記資料庫連結比對，推估台灣結核病「未通報」數與「延遲通報」數，同時進一步探討相關影響因素。方法：本研究連結比對民國92年結核病通報登記資料庫與健保申報資料庫，得出「未通報」與「延遲通報」之數目與比例。接下來以醫院層級別、患者性別年齡別、分局別分層分析，瞭解相關影響因素。結果：肺結核或是肺外結核延遲（大於等於八天）通報率已經由2002年的15%降到2003年不到1%。在不同醫院層級中，慢防體系延遲通報率（1.27%）較高。男性高於女性，第六分局延遲通報率最低。縣市別差異，除了澎湖縣人數較少外，最高的縣市是台南縣與屏東縣。醫院別有相當大差異，最高是台北榮總。結論：雖然表面上在民國92年延遲通報率已經非常低，其實連結健保資料可發現有相當多很早就已經出現過結核病診斷，未來還應該要針對這些情形進行醫院抽查求證。
Background: A accurate and timely surveillance system is paramount important to infectious disease control. After the reformed tuberculosis prevention system, the notification system is in high priority. Nevertheless, very few studies focused on the delay and non-reporting of tuberculosis cases and associated factors. Objectives: To determine the delay reporting of tuberculosis cases through the linkage of National Health Insurance Claims data and notification data of Center for Disease Control. Methods: We used the notification data of the year 2002 through 2003 from Center for Disease Control of Taiwan. These notified cases were then linked to the NHI claims data. Our primary indicator was the day between the first diagnosis of tuberculosis and notification day. We then analyzed the delay reporting by hospital level, age and bureau. Results: The delay report rate decreased to less than 1% in 2003. The delay report rates varied with different hospital level and county. The linkage record revealed that more than ten thousands of cased had tuberculosis diagnosis before they reported the cases to CDC. Conclusions: Further study should focus on these hidden delay reporting cases.
