Os objetivos deste estudo são analisar o perfil de morbi-mortalidade em idosos hospitalizados em dois hospitais universitários e dois não universitários, da Área de planejamento 2.2 da cidade do Rio de Janeiro, Brasil, no ano de 1999, comparando as taxas de mortalidade hospitalar, ajustando para diferenças no perfil. Os dados foram obtidos do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS). O modelo logístico foi ajustado incluindo as variáveis idade e diagnóstico primário, utilizado para calcular as taxas de mortalidade hospitalar ajustadas. As internações hospitalares em idosos (n = 7.584) representaram 29,3% do total de 25.928 internações realizadas nessas unidades. Catarata senil (7,8%) foi a causa mais freqüente, seguida de hiperplasia de próstata (4,7%), insuficiência cardíaca congestiva (2,9%) e bloqueio atrioventricular total (2,8%). Os hospitais não universitários apresentaram taxas de mortalidade hospitalar maiores do que as dos hospitais universitários, mesmo depois do ajuste para diferenças no perfil de casos em relação à idade e diagnóstico principal. O uso dos bancos de dados do SIH/SUS e da metodologia de ajuste de risco representam uma alternativa para avaliações exploratórias de resultados de cuidados de saúde.

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Descritores Relacionamento probabilístico de registros. Inquérito domiciliar. Dados de faturamento hospitalar. Abstract ObjectiveTo evaluate the potential advantages and limitations of the use of the Brazilian hospital admission authorization forms database and the probabilistic record linkage methodology for the validation of reported utilization of hospital care services in household surveys. Methods A total of 2,288 households interviews were conducted in the county of Duque de Caxias, Brazil. Information on the occurrence of at least one hospital admission in the year preceding the interview was obtained from a total of 10,733 household members. The 130 records of household members who reported at least one hospital admission in a public hospital were linked to a hospital database with 801,587 records, using an automatic probabilistic approach combined with an extensive clerical review. Results Seventy-four (57%) of the 130 household members were identified in the hospital database. Yet only 60 subjects (46%) showed a record of hospitalization in the hospital database in the study period. Hospital admissions due to a surgery procedure were significantly more likely to have been identified in the hospital database. The low level of concordance seen in the study can be explained by the following factors: errors in the linkage process; a telescoping effect; and an incomplete record in the hospital database. ConclusionsThe use of hospital administrative databases and probabilistic linkage methodology may represent a methodological alternative for the validation of reported utilization of health care services, but some strategies should be employed in order to minimize the problems related to the use of this methodology in non-ideal conditions. Ideally, a single identifier, such as a personal health insurance number, and the universal coverage of the database would be desirable. Resumo Objetivo Avaliar as potenciais vantagens e limitações do uso das bases de dados dos formulários de Autorização de Internação Hospitalar e da metodologia do relacionamento probabilístico de registros, para a validação de relatos de utilização de serviços hospitalares durante inquéritos domiciliares.

Prevalence and intensity of Ascaris lumbricoides infection were analyzed by a cross-sectional study in children addressed in the city of Duque de Caxias, Rio de Janeiro State, from July to December 1997. The study population consisted of children under two years of age (N=387) and mothers of children under one year of age (N=104). Coproparasitologic tests were run using the MIFC and the Kato thick smear (Kato-Katz) methods. Prevalence was 3.3% (95% CI: 1.0-7.8) for children under one year, 30.7% (95% CI: 25.4-36.4) for one-year-olds, and 42.3% (95% CI: 33.0-51.9) for mothers of children under one. Some 38.0% of children under one year of age showed medium-to-heavy infection. These results indicated that ascariasis was an important problem in the first year of life and demonstrated the need for research in the area of maternal and infantile ascariasis.