Uso do linkage para a melhoria da completude do SIM e do Sinasc nas capitais brasileiras

Abstract

OBJECTIVE To analyze the contribution of linkage between databases of live births and infant mortality to improve the completeness of the variables common to the Mortality Information System (SIM) and the Live Birth Information System (SINASC) in Brazilian capitals in 2012.METHODS We studied 9,001 deaths of children under one year registered in the SIM in 2012 and 1,424,691 live births present in the SINASC in 2011 and 2012. The databases were related with linkage in two steps – deterministic and probabilistic. We calculated the percentage of incompleteness of the variables common to the SIM and SINASC before and after using the technique.RESULTS We could relate 90.8% of the deaths to their respective declarations of live birth, most of them paired deterministically. We found a higher percentage of pairs in Porto Alegre, Curitiba, and Campo Grande. In the capitals of the North region, the average of pairs was 84.2%; in the South region, this result reached 97.9%. The 11 variables common to the SIM and SINASC had 11,278 incomplete fields cumulatively, and we could recover 91.4% of the data after linkage. Before linkage, five variables presented excellent completeness in the SINASC in all Brazilian capitals, but only one variable had the same status in the SIM. After applying this technique, all 11 variables of the SINASC became excellent, while this occurred in seven variables of the SIM. The city of birth was significantly associated with the death component in the quality of the information.CONCLUSIONS Despite advances in the coverage and quality of the SIM and SINASC, problems in the completeness of the variables can still be identified, especially in the SIM. In this perspective, linkage can be used to qualify important information for the analysis of infant mortality.

Tendência da incompletude das estatísticas vitais no período neonatal, estado do Rio de Janeiro, 1999-2014*

“…11 With regard to the SIM system, variable completeness quality is lower than that of SINASC, in particular completeness of sociodemographic variables. 3,[12][13][14][16][17][18][19] There is a high proportion of data incompleteness on SIM, above all for the following variables: 'race/ skin color', maternal 'schooling', 'liveborn children' and 'stillborn children', maternal 'age' and 'length of pregnancy'. Even birth weight, which is a relevant indicator for women's and children's health, has a regular percentage of incomplete data.…”

“…20,21 In short, there continue to be problems with information quality, capable of both affecting the indicators used to inform public policies 2 and also producing bias in epidemiological studies. 18,19 With regard to the SIM system, variable completeness quality is lower than that of SINASC, in particular completeness of sociodemographic variables.…”

Ameaça à vida ao nascer: uma análise das causas de morte e estimativa de sobrevida de menores de cinco anos em coortes de nascidos vivos

“…The information system's quality has improved in Brazil, particularly in the SINASC 28,29 . The SIM still presents some deficiencies, but the database linkage qualifies the data and contributes to the study of infant mortality 30,31 . In the current study, besides mortality, it was possible to assess the impact of the prevention of life-threatening conditions at birth on the mortality rates in under-five children.…”

Análise da distribuição dos nascimentos com marcadores de gravidade em maternidades com unidade de terapia intensiva neonatal no Sistema Único de Saúde

“…Este trabalho não se propunha investigar o acesso ao serviço nem a resolutividade dos nascimentos com marcadores de gravidade. Para esse tipo de avaliação, seria necessária a vinculação dos dados do SINASC com o Sistema de Informação Hospitalar (SIH) e o Sistema de Informação sobre Mortalidade (SIM), o que demandaria o acesso à identificação dos pacientes (por meio do nome do recém-nascido, da filiação, do endereço, da data de nascimento, dentre outros) e a utilização de técnicas de vinculação probabilistas, uma vez que esses bancos de dados não apresentam identificadores comuns que permitam a vinculação determinística [19][20][21] .…”

“…Entretanto, esse campo ainda apresenta baixa completude, não permitindo a recuperação de um volume considerável de registros e prejudicando a realização de análises, por exemplo, da sobrevida dos nascidos vivos com marcadores de gravidade segundo o tipo de estabelecimento. Diante desse cenário, a vinculação probabilística, apesar de mais complexa, ainda se apresenta como a melhor opção para estudos que pretendem analisar a mortalidade ou a resolutividade do cuidado neonatal 19,22 .…”