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

Estudio de validación de internaciones obstétricas en el Sistema de Información Hospitalaria del Sistema Único de Salud para vigilancia de la morbilidad materna: Brasil, 2021-2022

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.

Keywords
Validation Study; Morbidity; Pregnancy; Postpartum Period; Hospital Information Systems; Statistical Databases

Study contributions

Main results

The SIH/SUS system had good recording coverage of obstetric hospitalizations, but a lower proportion of hospitalizations due to “complications during pregnancy”; and under-recording of the diagnoses and procedures assessed, except “ectopic pregnancy”.

Implications for services

The quality of hospital admission authorization (AIH) filling in needs to be improved, including recording diagnoses and procedures to identify hospitalization as obstetric hospitalization as well as complications in pregnancy and the postpartum period.

Perspectives

Improving the quality of AIH records is essential for the use of the SIH/SUS system in maternal morbidity surveillance, this being a strategy recommended for better obstetric care, being complementary to maternal mortality surveillance.