Marques Juliana Alves, Domingues Rosa Maria Soares Madeira, Dias Marcos Augusto Bastos, Coeli Claudia Medina, Saraceni Valéria, Pinheiro Rejane Sobrino
Programa de Pós-graduação em Gestão Urbana, Pontifícia Universidade Católica do Paraná, Londrina, Brasil.
Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2025 Feb 7;40(12):e00225623. doi: 10.1590/0102-311XPT225623. eCollection 2025.
This study aimed to evaluate the national coverage of birth registration within the Brazilian Hospital Information System of the Brazilian Unified National Health System (SIH/SUS), according to the hospital of birth, and identify associated institutional characteristics. A descriptive ecological study was conducted using available data from the SIH/SUS, the Brazilian Information System on Live Births (SINASC), and the Brazilian National Registry of Health Establishments (CNES) from 2012 to 2020. Hospital admissions of women aged 10 to 49 for vaginal childbirth or cesarean section in the SIH/SUS were compared to live birth records from hospital deliveries in SUS-contracted establishments with more than 100 live births per year in SINASC. Coverage was measured by the proportion of admissions for childbirth (SIH/SUS) in relation to the total number of live births in SINASC. Supervised classification models, decision trees, and random forests were used to identify hospital characteristics predictive of coverage. Coverage in the SIH/SUS was estimated at 86.9%, and 80.6% after excluding hospitals with > 100% coverage. Higher coverage rates were observed in the North and Northeast regions, whereas lower rates were seen in the South and Central-West regions. National coverage increased from 77.9% to 82.3% during the period. The main predictive factors were the proportion of cesarean sections, the number of obstetric beds of SUS, the administrative sphere, and facility size, with lower coverage in services with a higher proportion of cesarean sections. Inconsistencies in CNES registration were identified in SINASC. Birth registration coverage in the SIH/SUS is high across the country, though lower in hospitals with a high proportion of cesarean sections. Strategies for continuous improvement of quality for information system records are necessary.
本研究旨在根据出生医院，评估巴西统一国家卫生系统（SIH/SUS）巴西医院信息系统内出生登记的全国覆盖率，并确定相关的机构特征。使用2012年至2020年SIH/SUS、巴西活产信息系统（SINASC）和巴西国家卫生机构登记处（CNES）的现有数据进行了描述性生态研究。将SIH/SUS中10至49岁因阴道分娩或剖宫产入院的女性与SINASC中每年有超过100例活产的SUS签约机构的医院分娩活产记录进行比较。覆盖率通过分娩入院人数（SIH/SUS）占SINASC活产总数的比例来衡量。使用监督分类模型、决策树和随机森林来识别预测覆盖率的医院特征。SIH/SUS中的覆盖率估计为86.9%，排除覆盖率>100%的医院后为80.6%。北部和东北部地区的覆盖率较高，而南部和中西部地区的覆盖率较低。在此期间，全国覆盖率从77.9%提高到了82.3%。主要预测因素是剖宫产比例、SUS产科床位数量、行政区域和机构规模，剖宫产比例较高的服务覆盖率较低。在SINASC中发现了CNES登记中的不一致情况。SIH/SUS中的出生登记覆盖率在全国范围内较高，但剖宫产比例高的医院覆盖率较低。有必要采取持续改进信息系统记录质量的策略。
