Análise da fidedignidade dos dados estatísticos hospitalares disponíveis na Secretaria de Estado da Saúde de São Paulo em 1974

Lebrão, Maria Lúcia

doi:10.1590/s0034-89101978000200014

“…In the present study, it was not sought to analyze the specifi city of codes assigned (for example, the type of accident or the type of victim in transport accidents, or furthermore, the way in which a fall occurred), although the importance of these factors for surveillance of these events is recognized. 7 Concern regarding improvements to the quality of information on external causes of hospitalizations in Brazil is not recent, 9,11 and this fi eld of study is not limited to Brazilian researchers. 1,7,12,13 The Ministry of Health's decision to make it mandatory to insert a code for the external cause in the HIS-SUS database, for all hospitalizations due to injuries, poisoning or other consequences of accidents or violent events, is in keeping with the proposals from the Centers for Disease Control and Prevention (CDC) for improving the quality of information on these causes, in relation to hospitalizations in the United States.…”

Section: Discussionmentioning

confidence: 99%

Qualidade da informação sobre causas externas no Sistema de Informações Hospitalares

Tomimatsu¹,

Andrade²,

Soares³

et al. 2009

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OBJECTIVE:To analyze the coverage and quality of the data on hospitalizations due to external causes in the Hospital Information System of the Brazilian National Health System. METHODS:Hospitalizations recorded in the Hospital Information System of 11 hospitals in two municipalities (Londrina and Maringá, Southern Brazil), in 2004, were compared with hospitalizations identifi ed as consequences of external causes through investigating medical records, complemented with mortality and pre-hospital data. The crude agreement rate, sensitivity and positive predictive value were calculated. The profi le of groups of hospitalization causes recorded in the System was compared with that obtained from investigations. RESULTS:In Londrina, 3,002 hospitalizations due to external causes were recorded in the System and, in Maringá, 1,403. The investigations found 4,018 and 2,370, respectively. The System presented high positive predictive values for hospitalizations due to external causes in both municipalities: 97.7% in Londrina and 98.6% in Maringá. However, the sensitivity was low: 57.3% in Maringá and 73% in Londrina, thus denoting underrecording of these causes. Comparison between the profi les of the types of causes revealed that there was underestimation of some causes in the System, especially regarding accidents due to exposure to inanimate mechanical forces, assaults and intentional self-harm. CONCLUSIONS:Underrecording of hospitalizations due to external causes and some distortions regarding the types of causes occurred in the Hospital Information System in both municipalities. Detection of these defi ciencies may contribute towards the process of improving the quality of the information in this System.

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“…6,9,11,20,a Only three of these allowed some type of evaluation on the quality of the information on accidents or violent events. 9,11,a Specifi cally in relation to hospitalizations due to external causes, Lebrão 9 in 1974 observed that the sensitivity of the information in the State Health Department of São Paulo was 83.3%, in comparison with the same data from hospital medical fi les. Thus, around 17% of the cases would not have been recognized in that Department's statistics if no search in the medical fi les had been undertaken.…”

Section: Discussionmentioning

confidence: 99%

Qualidade da informação sobre causas externas no Sistema de Informações Hospitalares

Tomimatsu¹,

Andrade²,

Soares³

et al. 2009

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OBJECTIVE:To analyze the coverage and quality of the data on hospitalizations due to external causes in the Hospital Information System of the Brazilian National Health System. METHODS:Hospitalizations recorded in the Hospital Information System of 11 hospitals in two municipalities (Londrina and Maringá, Southern Brazil), in 2004, were compared with hospitalizations identifi ed as consequences of external causes through investigating medical records, complemented with mortality and pre-hospital data. The crude agreement rate, sensitivity and positive predictive value were calculated. The profi le of groups of hospitalization causes recorded in the System was compared with that obtained from investigations. RESULTS:In Londrina, 3,002 hospitalizations due to external causes were recorded in the System and, in Maringá, 1,403. The investigations found 4,018 and 2,370, respectively. The System presented high positive predictive values for hospitalizations due to external causes in both municipalities: 97.7% in Londrina and 98.6% in Maringá. However, the sensitivity was low: 57.3% in Maringá and 73% in Londrina, thus denoting underrecording of these causes. Comparison between the profi les of the types of causes revealed that there was underestimation of some causes in the System, especially regarding accidents due to exposure to inanimate mechanical forces, assaults and intentional self-harm. CONCLUSIONS:Underrecording of hospitalizations due to external causes and some distortions regarding the types of causes occurred in the Hospital Information System in both municipalities. Detection of these defi ciencies may contribute towards the process of improving the quality of the information in this System.

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“…Além disso, estudo recente em hospitais de ensino do estado do Rio de Janeiro demonstrou grande proporção de prontuários incompletos, avaliando a qualidade do prontuário como ruim. [12][13][14][15][16] Essa situação define a pergunta de pesquisa em estudo: com que confiança podemos afirmar que a internação é uma CSAP, quando classificamos o campo diagnóstico principal da AIH segundo a Lista Brasileira de Internações por CSAP? A acurácia dessa classificação pode ser estimada pela sua concordância com a classificação resultante da análise do prontuário clínico do paciente.…”

Section: Métodounclassified

Condições Sensíveis À Atenção Primária: Confiabilidade Diagnóstica Em Santa Cruz Do Sul, Rs

Abaid

¹

,

Nedel²,

Alcayaga

³

2014

Rev Epidemiol Control Infect

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O estudo das hospitalizações por condições sensíveis à atenção primária (CSAP) tem-se difundido no Brasil pela tabulação dos dados da Autorização de Internação Hospitalar (AIH), entretanto a confiabilidade dos resultados é ainda desconhecida. O objetivo principal do estudo foi estimar a concordância entre o diagnóstico principal da AIH e o prontuário médico, para a classificação da internação como CSAP. Dois médicos avaliaram uma amostra aleatória de 400 prontuários onde 32% das internações eram por CSAP. O índice kappa para toda a amostra foi 0,784 (IC95% 0,71-0,85). A concordância foi no mínimo moderada em todas as faixas etárias e nas especialidades de clínica médica e na pediatria. A sensibilidade, especificidade e valores preditivos positivo e negativo da AIH para a classificação da internação como CSAP ou não foram, respectivamente, 78,2; 97,0; 92,4 e 90,5. Os resultados indicaram que a AIH é uma ferramenta confiável para a classificação da hospitalização como CSAP. Para corroborar estes resultados, novas pesquisas com foco nesta problemática são altamente desejáveis.Introduction: Ambulatory Care Sensitive Conditions (ACSC) are illnesses that could be prevented with adjusted ambulatorial care. ACSC have been used as indicator in effectiveness of the primary healthcare attention, through the evaluation of hospital admissions. However, we do not have studies to certify the reliability of diagnosis of ACSC in our country. Objective: To determine if the classification of ACSC from the main diagnostic field of the authorization of hospital internment (AHI) is reliable. Methods: Transversal study carried through February of 2010 to January of 2011, in the city of Santa Cruz of Sul (RS). A random sample of 389 medical records was selected and evaluated by two medical appraisers. The main diagnosis in the AHI was compared with the classification in ACSC or not ACSC given for the appraisers after the study of each medical record. Kappa ratio agreement was used to calculate the reliability of the ACSC diagnostic. Results: The ratio of agreement between diagnosis from the AIH and CSAP assessment contained in the records was 92%, with a kappa coefficient of 0,784. Conclusions:The diagnostic of ACSC found in main diagnostic field of AHI showed agreement ratios over expected by chance, with kappa value equal to 0.784 and the correlation rated between substantial and almost perfect. RESUMO ABSTRACT ARTIGO ORIGINAL Condições sensíveis à atenção primária: confiabilidade diagnóstica em Santa Cruz do Sul, RS MÉTODOUm estudo transversal, baseado em registros hospitalares pré-existentes foi realizado em Santa Cruz do Sul, município de aproximadamente 120 mil habitantes no interior do Rio Grande do Sul, com 10.198 internações pelo SUS no período analisado, de 1º fevereiro de 2010 a 31 de janeiro de 2011. Foi selecionado o Hospital Santa Cruz (HSC), que conta com maior número de internações pelo SUS na cidade (117 leitos para o SUS, de um total de 189 leitos na época da pesquisa). O hospital é referência regional em traumatolog...

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Análise da fidedignidade dos dados estatísticos hospitalares disponíveis na Secretaria de Estado da Saúde de São Paulo em 1974

Cited by 11 publications

References 4 publications

Qualidade da informação sobre causas externas no Sistema de Informações Hospitalares

Qualidade da informação sobre causas externas no Sistema de Informações Hospitalares

Qualidade da informação sobre causas externas no Sistema de Informações Hospitalares

Condições Sensíveis À Atenção Primária: Confiabilidade Diagnóstica Em Santa Cruz Do Sul, Rs

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