OBJECTIVE:To analyze underreporting of deaths and hospital admissions from tuberculosis to the Information System for Notifi able Diseases (SINAN). METHODS:Cases with tuberculosis as basic or associated cause of death were selected from the Brazilian Mortality Information System (SIM) and hospital admissions for tuberculosis as main or secondary cause from the Hospital Information System of the Brazilian Unifi ed Health System (SIH-SUS), for residents in the municipality of Rio de Janeiro in 2004. Probabilistic record linkage was carried out between the SIM and SIH-SUS databases and the SINAN for the years 2002 to 2004. RESULTS:Out of the 542 deaths from tuberculosis in the period, 234 (43.2%) were not registered in the SINAN for the two previous years. As for the 1,079 admissions, 238 (22.1%) failed to be notifi ed. Seventy-one deaths were related to these admissions: 47 were registered out of the SIH-SUS by death, 24 occurred after discharge and seven remained unnotifi ed in the SINAN. The elderly were 1.6 times (95%CI 1.074;2.516) less likely to be notifi ed than younger patients, and those with at least a college education were 3.6 times (95%CI 1.384;11.022) less likely to be notifi ed than those with no formal education. Patients under 15 were 4.8 times (95%CI 2.757;8.452) less likely to be notifi ed than those aged between 15 and 59 years. Some regional health administration divisions showed a percentage of unnotifi ed deaths of over 50% and this percentage ranged from 37.8% to 12.7% for hospital admissions. CONCLUSIONS:The data suggest problems in the detection of cases and point to obstacles in adequate and timely treatment, as well as to quality fl aws in the information system, with differences among regions in the municipality.
Caracterização do acesso à assistência ao parto normal na Bahia, Brasil, a partir da teoria dos grafos Characterization of access to normal childbirth care in Bahia State, Brazil, based on graph theory Caracterización del acceso a la asistencia en el parto normal en Bahía, Brasil, a partir de la teoría de grafos
Introduction The transformation of data into information is important to support decision making and, thus, to induce improvements in healthcare services. The regionalized organization of healthcare systems is necessary to ensure the integrity of citizen care. From this perspective, the creation of mechanisms to guide and assess the behavior of a healthcare services network becomes necessary. However, these mechanisms must consider the interaction between different municipalities. The objective of this study is to apply network analysis as a supporting tool in the Brazilian Unified Health System (Sistema Único de Saúde—SUS) management. Methods The stages of the proposed method are described and applied in a real situation, analyzing the intermunicipal interaction network for cardiovascular surgery in the municipality of Vitória da Conquista, Bahia, Brazil, from 2008 to 2020. The metrics analyzed were journeys indices, flow of patients and distance of the journeys, considering the journeys from and to the municipality in focus. Result There was an increase of the incoming flow and in-degree indices combined with a decrease in outgoing flow, showing the growing importance of this municipality as a provider of these services. Conclusion The method used in the study has potential to be adopted as a management tool to assess the behavior of the interactions network of the selected service, aiding the regionalized organization of the healthcare system.
Introduction: The transformation of data into information is important to support decision making and, thus, to induce improvements in healthcare services. The regionalized organization of healthcare systems is necessary to ensure the integrity of citizen care. From this perspective, the creation of mechanisms to guide and assess the behavior of a healthcare services network becomes necessary. However, these mechanisms must consider the interaction between different municipalities. The objective of this study is to apply network analysis as a supporting tool in the Brazilian Unified Health System (Sistema Único de Saúde - SUS) management.Methods: the stages of the proposed method are described and applied in a real situation, analyzing the intermunicipal interaction network for cardiovascular surgery in the municipality of Vitória da Conquista, Bahia, Brazil, from 2008 to 2020. The metrics analyzed were journeys indices, flow of patients and distance of the journeys, considering the journeys from and to the municipality in focus. Result: there was an increase of the incoming flow and in-degree indices combined with a decrease in outgoing flow, showing the growing importance of this municipality as a provider of these services. Conclusion: the method used in the study has potential to be adopted as a management tool to assess the behavior of the interactions network of the selected service, aiding the regionalized organization of the healthcare system.
Introduction: The transformation of data into information is important to support decision making and, thus, to induce improvements in healthcare services. The regionalized organization of healthcare systems is necessary to ensure the integrity of citizen care. From this perspective, the creation of mechanisms to guide and assess the behavior of a healthcare services network becomes necessary. However, these mechanisms must consider the interaction between different municipalities. The objective of this study is to apply network analysis as a supporting tool in the Brazilian Unified Health System (Sistema Único de Saúde - SUS) management. Methods: the stages of the proposed method are described and applied in a real situation, analyzing the intermunicipal interaction network for cardiovascular surgery in the municipality of Vitória da Conquista, Bahia, Brazil, from 2008 to 2020. The metrics analyzed were journeys indices, flow of patients and distance of the journeys, considering the journeys from and to the municipality in focus. Result: there was an increase of the incoming flow and in-degree indices combined with a decrease in outgoing flow, showing the growing importance of this municipality as a provider of these services. Conclusion: the method used in the study has potential to be adopted as a management tool to assess the behavior of the interactions network of the selected service, aiding the regionalized organization of the healthcare system.
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