Validation study of obstetric hospitalization data held on the Brazilian National Health System Hospital Information System for maternal morbidity surveillance: Brazil, 2021-2022

Epidemiol Serv Saude. 2024 Jul 29:33:e20231252. doi: 10.1590/S2237-96222024v33e20231252.en. eCollection 2024.
[Article in English, Portuguese]

Abstract

Objective: To validate the Brazilian National Health System Hospital Information System (SIH/SUS) for maternal morbidity surveillance.

Methods: This was a cross-sectional study conducted in 2021/2022, taking as its reference a national study on maternal morbidity (MMG) conducted in 50 public and 28 private hospitals; we compared SIH/SUS and MMG data for hospitalization frequency, reason and type of discharge and calculated sensitivity, specificity, positive and negative likelihood ratios for seven diagnoses and four procedures.

Results: Hospitalizations identified on SIH/SUS (32,212) corresponded to 95.1% of hospitalizations assessed by MMG (33,867), with lower recording on SIH/SUS (85.5%) for private hospitals [10,036 (SIH/SUS)]; 11,742 (MMG)]; compared to MMG, SIH/SUS had a lower proportion of hospitalizations due to "complications during pregnancy" (9.7% versus 16.5%) as well as under-recording of all diagnoses and procedures assessed, except "ectopic pregnancy".

Conclusion: Better recording of diagnoses and procedures on SIH/SUS is essential for its use in maternal morbidity surveillance.

Objetivo: Validar el Sistema de Información Hospitalaria del Sistema Único de Salud (SIH/SUS) para vigilancia de la morbilidad materna.

Métodos: Estudio transversal, 2021/2022, utilizando como referencia datos de estudio nacional de morbilidad materna (MMG) realizado en 50 hospitales públicos y 28 privados; comparando: frecuencia, motivo y tipo de alta de internaciones en SIH/SUS y MMG y calculando sensibilidad, especificidad y razones de probabilidad positivos y negativos para siete diagnósticos y cuatro procedimientos.

Resultados: Las internaciones identificadas en SIH/SUS (32.212) correspondieron al 95,1% de internaciones evaluadas en MMG (33.867), observándose menor registro en SIH/SUS (85,5%) en hospitales privados [10.036 (SIH/SUS)]; 11.742 (MMG)]; comparado con MMG, SIH/SUS tuvo menor proporción de internaciones por “complicaciones durante el embarazo” (9,7% vs 16,5%), así como subregistro de todos los diagnósticos y procedimientos evaluados, excepto “embarazo ectópico”.

Conclusión: Mejor registro de diagnósticos y procedimientos en SIH/SUS es fundamental para su uso en la vigilancia de la morbilidad materna.

Publication types

  • Validation Study

MeSH terms

  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Female
  • Hospital Information Systems*
  • Hospitalization* / statistics & numerical data
  • Hospitals, Private / statistics & numerical data
  • Hospitals, Public / statistics & numerical data
  • Humans
  • Morbidity / trends
  • National Health Programs
  • Population Surveillance / methods
  • Pregnancy
  • Pregnancy Complications* / epidemiology
  • Sensitivity and Specificity