Trends in mortality from ill-defined causes among the elderly in Brazil, 1979-2013: ecological study

Df, Martins; Rd, Felzemburg; Ab, Dias; Tm, Costa Pinho; Pn, Santos

doi:10.1590/1516-3180.2016.0070010616

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…The highest proportion of GCs occurred among elderly people, especially those over 80 years (49.6%) and were due mainly to level 4 GCs. Higher proportions of ill-defined causes among the elderly are probably due to the higher number of comorbidities, such as neoplasms, hypertension, diabetes, and other cardiovascular diseases, making it difficult to provide information on the underlying cause of death during the completion of the DC [18][19][20], even after the use of verbal autopsies [21]. On the other hand, Fig.…”

Section: Discussionmentioning

confidence: 99%

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016

França

Ishitani

Teixeira

et al. 2020

Popul Health Metrics

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Background Registered causes in vital statistics classified as garbage codes (GC) are considered indicators of quality of cause-of-death data. Our aim was to describe temporal changes in this quality in Brazil, and the leading GCs according to levels assembled for the Global Burden of Disease (GBD) study. We also assessed socioeconomic differences in the burden of different levels of GCs at a regional level. Methods We extracted data from the Brazilian Mortality Information System from 1996 to 2016. All three- and four-digit ICD-10 codes considered GC were selected and classified into four categories, according to the GBD study proposal. GC levels 1 and 2 are the most damaging unusable codes, or major GCs. Proportionate distribution of deaths by GC levels according selected variables were performed. Age-standardized mortality rates after correction of underreporting of deaths were calculated to investigate temporal relationships as was the linear association adjusted for completeness between GC rates in states and the Sociodemographic Index (SDI) from the GBD study, for 1996–2005 and 2006–2016. We classified Brazilian states into three classes of development by applying tertiles cutoffs in the SDI state-level estimates. Results Age-standardized mortality rates due to GCs in Brazil decreased from 1996 to 2016, particularly level 1 GCs. The most important GC groups were ill-defined causes (level 1) in 1996, and pneumonia unspecified (level 4) in 2016. At state level, there was a significant inverse association between SDI and the rate of level 1–2 GCs in 1996–2005, but both SDI and completeness had a non-expected significant direct association with levels 3–4. In 2006–2016, states with higher SDIs tended to have lower rates of all types of GCs. Mortality rates due to major GCs decreased in all three SDI classes in 1996–2016, but GC levels 3–4 decreased only in the high SDI category. States classified in the low or medium SDI groups were responsible for the most important decline of major GCs. Conclusion Occurrence of major GCs are associated with socioeconomic determinants over time in Brazil. Their reduction with decreasing disparity in rates between socioeconomic groups indicates progress in reducing inequalities and strengthening cause-of-death statistics in the country.

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Section: Discussionmentioning

confidence: 99%

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016

França

Ishitani

Teixeira

et al. 2020

Popul Health Metrics

View full text Add to dashboard Cite

show abstract

“…The highest proportion of GCs occurred among elderly people, especially those over 80 years (49.6%), and were due mainly to level 4 GCs. Higher proportions of ill-de ned causes among the elderly are probably due to the higher number of comorbidities, such as neoplasms, hypertension, diabetes and other cardiovascular diseases, making it di cult to provide information on the underlying cause of death during the completion of the DC [18,19,20], even after the use of verbal autopsies [21]. On the other hand, children aged 1-14 years also had a high fraction of major GCs, more than 20%.…”

Section: Discussionmentioning

confidence: 99%

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996-2016

França

Ishitani

Teixeira

et al. 2020

Preprint

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Background: Registered causes in vital statistics classified as garbage codes (GC) are considered indicators of quality of cause-of-death data. Our aim was to describe temporal changes in this quality in Brazil, and the leading GCs according to levels assembled for the Global Burden of Disease (GBD) study. We also assessed socioeconomic differences in the burden of different levels of GCs at a regional level. Methods: We extracted data from the Brazilian Mortality Information System from 1996 to 2016. All three and four digit ICD-10 codes considered as GC were selected and classified into four categories, according to the GBD study proposal. GCs levels 1 and 2 are the most damaging unusable codes, or major GCs. Proportionate distribution of deaths by GC levels according selected variables were performed. Age-standardized mortality rates after correction of underreporting of deaths were calculated to investigate temporal relationships as was the linear association adjusted for completeness between GC rates in states and the Sociodemographic Index (SDI) from the GBD study, for 1996-2005 and 2006-2016. We classified Brazilian states into three classes of development by applying tertiles cutoffs in the SDI state‐level estimates. Results: Age-standardized mortality rates due to GCs in Brazil decreased from 1996 to 2016, particularly level 1 GCs. The most important GC groups were ill-defined causes (level 1) in 1996, and pneumonia unspecified (level 4) in 2016. At state level, there was a significant inverse association between SDI and the rate of level 1-2 GCs in 1996-2005, but both SDI and completeness had a non-expected significant direct association with levels 3-4. In 2006-2016, states with higher SDIs tended to have lower rates of all types of GCs. Mortality rates due to major GCs decreased in all three SDI classes in 1996-2016, but GCs levels 3-4 decreased only in the high SDI category. States classified in the low or medium SDI groups were responsible for the most important decline of major GCs. Conclusion: Occurrence of major GCs are associated with socioeconomic determinants over time in Brazil. Their reduction with decreasing disparity in rates between socioeconomic groups indicates progress in reducing inequalities and strengthening cause-of-death statistics in the country.

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“…Em estudos ecológicos, que investigam a influência do contexto em questões específicas, é frequente a identificação de indicadores de desigualdade de renda 21-23 , de desenvolvimento humano 22-24 e assistenciais 25-2 7 influenciando questões relacionadas à saúde 22,23,25 e asssistência 23,27,28 . Dessa forma, acreditava-se, inicialmente, que os salários pagos aos médicos contratados também seriam influenciados por tais indicadores, o que, na prática, não se confirmou.…”

Section: Discussionunclassified

Salário de médicos contratados da Estratégia Saúde da Família e contexto municipal: estudo ecológico

et al. 2020

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RESUMO O salário é um importante fator de atração, fixação e satisfação de profissionais médicos na Atenção Primária à Saúde (APS), sobretudo nas regiões mais remotas ou carentes. Este estudo tem o objetivo de identificar características contextuais municipais que estejam associadas ao valor do salário pago a médicos contratados da Estratégia Saúde da Família (ESF). Realizou-se um estudo ecológico e transversal com 78 municípios da Macrorregião de Saúde Norte, Minas Gerais, Brasil. A variável dependente referiu-se ao valor pago aos médicos contratados da ESF. Foram consideradas 22 variáveis independentes contextuais incluindo características sociodemográficas, de localização e indicadores assistenciais e de saúde de cada município, coletados de bases de dados oficiais. Conduziu-se Regressão Linear Múltipla. A média salarial encontrada foi de R$11.188,61 (±R$2.093,71), variando de R$6.388,20 até R$17.000,00. Após ajuste do modelo, somente a Distância ao Centro Regional manteve-se positivamente associada ao desfecho (R2=6,4%). O salário dos médicos não foi determinado por características municipais contextuais mensuráveis. Outros fatores mais subjetivos, de difícil mensuração, podem estar envolvidos na questão. Observa-se a necessidade do estabelecimento de parâmetros claros para definição do valor do salário de médicos contratados para atuação na ESF.

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Trends in mortality from ill-defined causes among the elderly in Brazil, 1979-2013: ecological study

Cited by 7 publications

References 12 publications

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996-2016

Salário de médicos contratados da Estratégia Saúde da Família e contexto municipal: estudo ecológico

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