Silva Maura Carolina Belomé da, Knauth Daniela Riva, Borges Rogério Boff, Nunes Luciana Neves, Giugliani Camila
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
Secretaria Estadual da Saúde do Rio Grande do Sul, Porto Alegre, Brasil.
Cad Saude Publica. 2021 Nov 22;37(11):e00282920. doi: 10.1590/0102-311X00282920. eCollection 2021.
Abortion as allowed by law in Brazil is a right that is rarely enforced, due to the multiple barriers to access. Another troublesome issue related to the health system's organization is the difficulty in obtaining reliable and easily accessible records to back monitoring and evaluation of legally authorized abortion. The current study thus aimed to analyze the patient records of women that had undergone legal abortion in the city of Porto Alegre, Rio Grande do Sul State, from 2013 to 2018 and to identify the procedure's prevalence in the Hospital Information System (SIH). The study analyzed on site the patient files for legally permitted abortions performed in the four referral services in the city. The authors cross-analyzed the data with the database of the SIH under the Brazilian Unified National Health System (SUS). Prevalence ratio was estimated with a Poisson regression model with robust variance. Examination of the patient files identified 236 cases of legal abortion, of which 95 (40.3%) were recorded in the SIH. The cases in which the patient files contained ICD O04 (medical abortion) identified in their internal records had 3.02 times higher prevalence (95%CI: 1.83-4.98) of being recorded in the SIH than those without the ICD code. The number of records of legal abortions in the SIH differed according to the hospital. However, independently of the hospital, the fact that the internal record listed ICD O04 increased the prevalence of records in the SIH. In conclusion, the lack of standardization and under-recording hindered the collection of trustworthy information in the national database of the SUS, further increasing the invisibility of legal abortion in Brazil.
在巴西，法律允许的堕胎是一项很少得到执行的权利，因为存在多种获取途径的障碍。与卫生系统组织相关的另一个棘手问题是，难以获得可靠且易于获取的记录来支持对合法授权堕胎的监测和评估。因此，本研究旨在分析2013年至2018年在南里奥格兰德州阿雷格里港市接受合法堕胎的女性的病历，并确定该手术在医院信息系统（SIH）中的发生率。该研究在现场分析了该市四家转诊服务机构中进行的合法堕胎患者档案。作者将这些数据与巴西统一国家卫生系统（SUS）下的SIH数据库进行了交叉分析。采用具有稳健方差的泊松回归模型估计患病率。对患者档案的检查确定了236例合法堕胎病例，其中95例（40.3%）记录在SIH中。患者档案内部记录中包含ICD O04（药物流产）的病例在SIH中的记录患病率比没有ICD代码的病例高3.02倍（95%CI：1.83-4.98）。SIH中合法堕胎的记录数量因医院而异。然而，无论医院如何，内部记录列出ICD O04这一事实增加了在SIH中的记录患病率。总之，缺乏标准化和记录不足阻碍了在SUS国家数据库中收集可靠信息，进一步加剧了巴西合法堕胎的隐匿性。
