09/10/2017 - 16:50 - 18:10
Sistemas de informações em saúde 1 |
17740 - GARBAGE CODE INVESTIGATION TO IMPROVE MORTALITY DATA IN BRAZIL: RESULT OF THE PILOT STUDY
MARIA DE FÁTIMA MARINHO DE SOUZA - MINISTÉRIO DA SAÚDE, ELISABETH FRANÇA - UNIVERSIDADE FEDERAL DE MINAS GERAIS, LENICE ISHITANI - UNIVERSIDADE FEDERAL DE MINAS GERAIS, ASHLEY FREDERES - VITAL STRATEGIES, VALÉRIA PASSOS - UNIVERSIDADE FEDERAL DE MINAS GERAIS, ALAN LOPEZ - UNIVERSITY OF MELBOURNE
Objectives: In Brazil, accurate medical certification and coding of underlying causes of death (COD) in accordance with the standards developed by WHO remains a challenge. This study aims to evaluate an innovative approach to determining underlying COD for each death, thus reducing the proportion of ill-defined, nonspecific or inappropriate codes, known as garbage codes (GC); and to assess the feasibility of this approach on a national scale. Methods: A structured strategy of GC investigation has been pilot-tested in seven cities, distributed across the five regions in Brazil. The health-service professionals recovered information from hospitals, outpatient clinics, Death Verification services or forensic institutes. A standardized verbal autopsy form was used to investigate domiciliary deaths. Results: In 2015, 5,583 deaths with the underlying cause assigned to a GC were reported in these cities; 1,141(20.8%) were investigated, of which 77.2% came from hospitals. The distribution of GC showed the majority of cases were classified to ill-defined codes and unspecified cardiovascular diseases. 1030 (90.3%) of the investigated deaths were reclassified to a specific cause group, with 650(63.1%) assigned to another ICD 10 chapter. Conclusion: This study provides scientific support to a national investigation of GCs. It was successfully done by health professionals involved in other activities, indicating its feasibility. The investigation and improvement of hospital records should be the priority of the further investigation. Since a large proportion of GCs could be reassigned to an appropriate underlying COD, rolling out this initiative at national level could significantly improve the cause of death statistics.
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