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预测巴西医院信息系统(SIH/SUS)记录育龄妇女死亡的因素,2012-2020 年。

Predictive factors for recording the death of women of childbearing age in the Hospital Information System (SIH/SUS), Brazil, 2012-2020.

机构信息

Pontifícia Universidade Católica do Paraná, Postgraduate Program in Urban Management - Curitiba (PR), Brazil.

Fundação Oswaldo Cruz, Evandro Chagas National Institute of Infectious Diseases - Rio de Janeiro (RJ), Brazil.

出版信息

Rev Bras Epidemiol. 2024 Nov 22;27:e240051. doi: 10.1590/1980-549720240051. eCollection 2024.

Abstract

OBJECTIVE

To estimate the death registration coverage of women of childbearing age (WCA) in the Hospital Information System (SIH), according to the hospital of occurrence and to verify the predictors associated with coverage.

METHODS

Descriptive ecological study with public data from SIH, Mortality Information System (SIM) and National Registry of Health Establishments (CNES), 2012-2020. Deaths in WCA hospitalizations in SIH were compared to those in SIM. Coverage was calculated by the proportion of deaths in SIH in relation to SIM. Supervised classification models - decision tree and random forest - were used to identify hospital characteristics related to coverage.

RESULTS

WCA death registration coverage was estimated at 78.0 and 71.8% after excluding hospitals with >100% coverage. Lower coverage was observed in the North region (67.7%) and higher in the South (76.9%). There was an increase in coverage from 69.0% to 74.4% in the period examined. The main factors predicting coverage were urgency/emergency facility, administrative management level, hospital complexity, proportion of adult beds covered by SUS and teaching activity, with lower coverage in those with an urgency/emergency facility and greater coverage in those of higher complexity, in federal hospitals, those with teaching activity and higher proportion of adult beds covered by SUS. Flaws in the CNES registration were identified in SIM.

CONCLUSION

The coverage of WCA death registration in SIH in the country is high and growing. Regional differences reinforce the need for strategies to improve the quality of information systems.

摘要

目的

根据发病医院估算医院信息系统(SIH)中育龄妇女(WCA)的死亡登记覆盖情况,并验证与覆盖情况相关的预测因素。

方法

这是一项具有公共数据的描述性生态研究,数据来自 SIH、死亡率信息系统(SIM)和国家卫生机构登记处(CNES),时间范围为 2012 年至 2020 年。将 SIH 中 WCA 住院患者的死亡情况与 SIM 进行比较。通过 SIH 中死亡人数与 SIM 中死亡人数的比例计算覆盖情况。使用监督分类模型——决策树和随机森林——来识别与覆盖情况相关的医院特征。

结果

排除覆盖范围超过 100%的医院后,WCA 死亡登记覆盖估计值分别为 78.0%和 71.8%。北部地区的覆盖范围较低(67.7%),南部地区的覆盖范围较高(76.9%)。在研究期间,覆盖范围从 69.0%增加到 74.4%。预测覆盖情况的主要因素是紧急/急诊设施、行政管理级别、医院复杂程度、SUS 覆盖的成人床位比例和教学活动,紧急/急诊设施比例较低的医院覆盖情况较差,而复杂程度较高的医院覆盖情况较好,联邦医院、有教学活动和 SUS 覆盖的成人床位比例较高的医院覆盖情况较好。在 SIM 中发现了 CNES 登记处的缺陷。

结论

该国 SIH 中 WCA 死亡登记的覆盖情况较高且呈上升趋势。地区差异强化了改进信息系统质量的策略的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7766/11653955/563b13b9d918/1980-5497-rbepid-27-e240051-gf01.jpg

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