Lobato Gustavo, Reichenheim Michael Eduardo, Coeli Claudia Medina
Departamento de Obstetrícia, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2008 Mar;24(3):606-14. doi: 10.1590/s0102-311x2008000300014.
This study aimed to evaluate the adequacy of the Hospital Information System of the National Unified Health System (SIH-SUS) in identifying cases of RhD hemolytic disease of the newborn (HDN) at the Fernandes Figueira Institute (IFF/FIOCRUZ) from 1998 to 2003. Neonatal records, data from the Medical Archives, and AIH (Hospital Admissions Authorization Form) data consolidated in the SIH-SUS were analyzed. Cases were identified according to the following fields: principal diagnosis, secondary diagnosis, and procedure performed. During the period studied, 194 cases of HDN were diagnosed. The Medical Archives registered 148 newborns with HDN, however only 147 AIHs were issued and 145 consolidated in the SIH-SUS. Among these 145 cases, 84 cited HDN as the principal diagnosis, while secondary diagnosis identified 38 additional cases and the procedures performed failed to identify any further cases. Thus, the SIH-SUS identified only 122 (62.9%) of the 194 cases of HDN treated at the IFF/FIOCRUZ. Although it is necessary to evaluate other units, the SIH-SUS does not appear to be reliable for monitoring HDN. Additional studies are essential for employing secondary administrative data in the context of epidemiological surveillance.
本研究旨在评估国家统一卫生系统(SIH-SUS)的医院信息系统在识别1998年至2003年期间费尔南德斯·菲格雷拉研究所(IFF/FIOCRUZ)新生儿RhD溶血病(HDN)病例方面的充分性。分析了新生儿记录、医学档案数据以及SIH-SUS中整合的AIH(医院入院授权表)数据。根据以下字段识别病例:主要诊断、次要诊断和所进行的手术。在研究期间,共诊断出194例HDN病例。医学档案记录了148例患有HDN的新生儿,但仅开具了147份AIH,其中145份在SIH-SUS中进行了整合。在这145例病例中,84例将HDN列为主要诊断,次要诊断又识别出38例额外病例,而所进行的手术未能识别出更多病例。因此,SIH-SUS仅识别出IFF/FIOCRUZ治疗的194例HDN病例中的122例(62.9%)。尽管有必要对其他单位进行评估,但SIH-SUS在监测HDN方面似乎并不可靠。在流行病学监测背景下使用二级行政数据,还需要进行更多研究。