2012-2020 年巴西医院信息系统(SIH/SUS)中记录育龄妇女死亡的预测因素。

Juliana Alves Marques, Rosa Maria Soares Madeira Domingues, Marcos Augusto Bastos Dias, Claudia Medina Coeli, Rejane Sobrinho Pinheiro, Valeria Saraceni
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引用次数: 0

摘要

摘要根据发病医院,估算医院信息系统(SIH)中育龄妇女(WCA)的死亡登记覆盖率,并验证与覆盖率相关的预测因素:方法:利用 2012-2020 年医院信息系统(SIH)、死亡率信息系统(SIM)和国家卫生机构登记处(CNES)的公共数据进行描述性生态研究。将 SIH 与 SIM 中的 WCA 住院死亡人数进行比较。覆盖率按 SIH 与 SIM 的死亡比例计算。监督分类模型--决策树和随机森林--用于识别与覆盖率相关的医院特征:排除覆盖率大于 100% 的医院后,WCA 死亡登记覆盖率估计分别为 78.0% 和 71.8%。北部地区的覆盖率较低(67.7%),南部地区较高(76.9%)。在调查期间,覆盖率从 69.0% 增加到 74.4%。预测覆盖率的主要因素是急诊/急救设施、行政管理水平、医院复杂程度、统一卫生系统覆盖的成人床位比例和教学活动,其中急诊/急救设施覆盖率较低,而复杂程度较高、联邦医院、有教学活动和统一卫生系统覆盖的成人床位比例较高的医院覆盖率较高。在 SIM 系统中发现了 CNES 登记的缺陷:结论:全国 SIH 的 WCA 死亡登记覆盖率很高,而且还在不断提高。地区差异加强了提高信息系统质量战略的必要性。
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Predictive factors for recording the death of women of childbearing age in the Hospital Information System (SIH/SUS), Brazil, 2012-2020.

Objective: To estimate the death registration coverage of women of childbearing age (WCA) in the Hospital Information System (SIH), according to the hospital of occurrence and to verify the predictors associated with coverage.

Methods: Descriptive ecological study with public data from SIH, Mortality Information System (SIM) and National Registry of Health Establishments (CNES), 2012-2020. Deaths in WCA hospitalizations in SIH were compared to those in SIM. Coverage was calculated by the proportion of deaths in SIH in relation to SIM. Supervised classification models - decision tree and random forest - were used to identify hospital characteristics related to coverage.

Results: WCA death registration coverage was estimated at 78.0 and 71.8% after excluding hospitals with >100% coverage. Lower coverage was observed in the North region (67.7%) and higher in the South (76.9%). There was an increase in coverage from 69.0% to 74.4% in the period examined. The main factors predicting coverage were urgency/emergency facility, administrative management level, hospital complexity, proportion of adult beds covered by SUS and teaching activity, with lower coverage in those with an urgency/emergency facility and greater coverage in those of higher complexity, in federal hospitals, those with teaching activity and higher proportion of adult beds covered by SUS. Flaws in the CNES registration were identified in SIM.

Conclusion: The coverage of WCA death registration in SIH in the country is high and growing. Regional differences reinforce the need for strategies to improve the quality of information systems.

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