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Title: Assessing the availability of casemix information in hospital database systems in Rio de Janeiro, Brazil
Authors: Martins, Mônica Silva
Travassos, Claudia Maria de Rezende
Affilliation: Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Departamento de Administração e Planejamento em Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Centro de Informação Científica e Tecnológica. Departamento de Informações em Saúde. Rio de Janeiro, RJ, Brasil.
Abstract: Objective. This article considers the possibility that using secondary diagnoses extracted from hospital medical records of patients would modify the diagnosis related groups (DRG) allocated to a case and the Charlson comorbidity index (CCI)calculated from data in the Brazilian hospital information system. Design. This study used two databases: the administrative database of the Brazilian health care system which consists of c1aim forms abstracted from medical records and is primarily linked to reimbursement, and the medical records that correspond to a sample of c1aims forms of which the first data source is composed. Changes in DRG were tested by analyzing percent of agreement and the K index. Logistic regression was employed to evaluate the impact of using CCI scores. Settings and patients. This study is based on a sample of c1aim forms and medical records (n = 1331) from a number of private acute-care hospitaIs which had contracts with the municipality of Rio de Janeiro in 1986. Results. Use of information on comorbidity shown in medical records caused changes both in the c1assification of cases into DRG and in the scores of the CCI. The impact of restrictions on the number of secondary diagnoses in the Brazilian administrative database is comparatively more important for the ccr than for DRG aIlocation since the Charlson method is based on an additional mode! where every case of comorbidity is taken into account cumulatively for the final score. Conclusion. These findings indicate the importance of taking a number of measures to improve the quality of information systems in arder to increase their potential role in the evaluation of Brazil's health services.
Keywords: casemix
Issue Date: 1998
Publisher: International Society for Quality in Health Care and Oxford University Press and Oxford University Press
Citation: MARTINS,Mônica; TRAVASSOS, Claudia. Assessing the availability of casemix information in hospital database systems in Rio de Janeiro, Brazil. International Journal for Quality in Health Care, v. 10, n. 2, p. 125-133, 1998.
ISSN: 1353-4505
Copyright: open access
Appears in Collections:ICICT - Artigos de Periódicos

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