Tomimatsu Maria Fátima Akemi Iwakura, Andrade Selma Maffei de, Soares Darli Antonio, Mathias Thais Aidar de Freitas, Sapata Maria da Penha Marques, Soares Dorotéia Fátima Pelissari de Paula, Souza Regina Kazue Tanno de
Autarquia Municipal de Saúde de Londrina, Londrina, PR, Brasil.
Rev Saude Publica. 2009 Jun;43(3):413-20. doi: 10.1590/s0034-89102009000300004. Epub 2009 Apr 3.
To analyze the coverage and quality of the data on hospitalizations due to external causes in the Hospital Information System of the Brazilian National Health System.
Hospitalizations recorded in the Hospital Information System of 11 hospitals in two municipalities (Londrina and Maringá, Southern Brazil), in 2004, were compared with hospitalizations identified as consequences of external causes through investigating medical records, complemented with mortality and pre-hospital data. The crude agreement rate, sensitivity and positive predictive value were calculated. The profile of groups of hospitalization causes recorded in the System was compared with that obtained from investigations.
In Londrina, 3,002 hospitalizations due to external causes were recorded in the System and, in Maringá, 1,403. The investigations found 4,018 and 2,370, respectively. The System presented high positive predictive values for hospitalizations due to external causes in both municipalities: 97.7% in Londrina and 98.6% in Maringá. However, the sensitivity was low: 57.3% in Maringá and 73% in Londrina, thus denoting underrecording of these causes. Comparison between the profiles of the types of causes revealed that there was underestimation of some causes in the System, especially regarding accidents due to exposure to inanimate mechanical forces, assaults and intentional self-harm.
Underrecording of hospitalizations due to external causes and some distortions regarding the types of causes occurred in the Hospital Information System in both municipalities. Detection of these deficiencies may contribute towards the process of improving the quality of the information in this System.
分析巴西国家卫生系统医院信息系统中外部原因导致的住院数据的覆盖范围和质量。
将2004年巴西南方两个城市（隆德里纳和马林加）11家医院的医院信息系统中记录的住院情况，与通过病历调查确定为外部原因导致的住院情况进行比较，并辅以死亡率和院前数据。计算粗一致率、敏感性和阳性预测值。将系统中记录的住院原因组概况与调查获得的概况进行比较。
在隆德里纳，系统记录了3002例因外部原因导致的住院病例，在马林加为1403例。调查分别发现了4018例和2370例。该系统在两个城市中因外部原因导致的住院病例均呈现出较高的阳性预测值：隆德里纳为97.7%，马林加为98.6%。然而，敏感性较低：马林加为57.3%，隆德里纳为73%，这表明这些原因的记录不足。对病因类型概况的比较显示，系统中存在对某些病因的低估，特别是关于暴露于无生命机械力导致的事故、袭击和故意自伤。
两个城市的医院信息系统均存在外部原因导致的住院病例记录不足以及病因类型的一些偏差。发现这些缺陷可能有助于改进该系统信息质量的过程。
