Diferenciais geográficos, socioeconômicos e demográficos da qualidade da informação da causa básica de morte dos idosos no Brasil

Abstract

This study identifies geographic, demographic, and socioeconomic 2,3 . No Brasil, apesar da expressiva melhora na coleta e qualidade dos dados de mortalidade 4 , ainda persistem problemas, destacando-se o sub-registro de óbitos e as falhas no preenchimento das informações, principalmente aquela referente à causa básica de morte 5,6,7 .A proporção de mortes por causas mal definidas, correspondentes ao capítulo XVIII da Classificação Internacional de Doenças -10 a Revisão (CID-10) 8 Sintomas, Sinais e Achados Anormais de Exames Clínicos e de Laboratório não Classificados em Outra Parte, tem sido amplamente utilizada e reconhecida como indicador para avaliar a qualidade da informação das causas de mortalidade 3,7,9,10,11 . Em muitos casos, essa proporção é resultado da falta de infraestrutura assistencial, condições para o diagnóstico de doenças e, ainda, capacitação profissional para preenchimento das DO 12 . Um percentual elevado de óbitos por causas mal definidas prejudica a compreensão do padrão, nível e causalidade da mortalidade 4,7 . No Brasil, análises da situação de saúde dos idosos ficam comprometidas pela elevada propor-ARTIGO ARTICLE

Uso do diagnóstico principal das internações do Sistema Único de Saúde para qualificar a informação sobre causa básica de mortes naturais em idosos

“…Ill-defined causes can also be highlighted among the main causes of deaths 4,6 , partially owing to the difficulty in identifying the underlying cause of the morbidity process, because of the complex chain of events that lead to death in the elderly 7 population and the high frequency of comorbidities in this age stratum 8 . Socioeconomic, demographic, and geographic inequalities such as education level, race/color, size of the municipality, and per capita gross domestic product also have shown to be linked to ill-defined causes of death in elderly people 9 . Strategies to qualify the causes of death have been developed and utilized to improve the description of the health status [10][11][12][13] , subsidizing measures of prevention 14 , particularly for the elderly 15 .…”

Elderly readmission and death after discharge from treatment of hip fracture, occurred in public hospitals from 2008 to 2010, Rio de Janeiro

“…The proportion of poorly defined causes in the study was 11.1% (ICD-10, R00-R99) and that of nonspecific causes was 11.7%, which, according to a study by Kanso et al 32 , suggests inadequate information quality. In the study of Jorge et al 33 , which was carried out in 2005, the proportion of poorly defined causes in elderly population (11.9%) was overcome by deaths whose basic causes were the diseases of the cardiovascular system, neoplasms, and respiratory diseases.…”

Fatores associados à mortalidade por causas inespecíficas e mal definidas no estado do Amazonas, Brasil, de 2006 a 2012

“…Ill-defined causes were concentrated in two categories, unattended deaths, notably outside the capital, and other ill-defined and unspecified causes of mortality, most frequently certified in Manaus. The predominance of the two categories, as well as their respective reverse ordering in Manaus and outside the capital were also observed in the analysis of mortality in the Brazilian elderly population 21 . In Belo Horizonte, Minas Gerais, other ill-defined and unspecified causes of mortality (R99) were certified in 5% of deaths between 2011 and 2013 22 .…”

“…In Belo Horizonte, Minas Gerais, other ill-defined and unspecified causes of mortality (R99) were certified in 5% of deaths between 2011 and 2013 22 . Regarding the most frequent nonspecific causes in AM between 2006 and 2012, essential (primary) hypertension (I10) and unspecified sepsis (A41.9) showed similar proportions in Belo Horizonte 22 and heart failure (I50) was prominent among deaths of Brazilian elderly 21 .…”