Qualidade na certificação de mortalidade e natalidade em um hospital universitário, Colômbia ano 2014
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Apr 8, 2019
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Jesús Rodríguez García
https://orcid.org/0000-0003-2316-3374
Angela Patricia Vega Landaeta
https://orcid.org/0000-0002-5115-817X
Luis Fernando Jaramillo
https://orcid.org/0000-0002-8539-6475
Yesika Fernández Ortiz
https://orcid.org/0000-0002-3508-8263
Zuly Bibiana Suarez Morales
https://orcid.org/0000-0001-8699-9617
María Elizabeth Vásquez Candia
https://orcid.org/0000-0001-9603-8916
https://orcid.org/0000-0003-2316-3374
Angela Patricia Vega Landaeta
https://orcid.org/0000-0002-5115-817X
Luis Fernando Jaramillo
https://orcid.org/0000-0002-8539-6475
Yesika Fernández Ortiz
https://orcid.org/0000-0002-3508-8263
Zuly Bibiana Suarez Morales
https://orcid.org/0000-0001-8699-9617
María Elizabeth Vásquez Candia
https://orcid.org/0000-0001-9603-8916
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Resumo
O objetivo deste estudo foi descrever e analisar o processo de certificação de morte e nascimento de um hospital de ensino em Bogotá no 2014, tanto em termos de fluxo de informação quanto de qualidade da causa de morte assignada. Uma metodologia para monitorar a qualidade e cobertura das estatísticas de nascimentos e mortes hospitalares foi desenhada. Durante sua prática de saúde pública, dezessete estudantes de nono semestre de Medicina participaram na coleta de informação sobre 511 registros clínicos de mortes não fetais, excluindo as mortes por causa externa que aconteceram em 2014 (58 % de todas as mortes não fetais acontecidas no hospital esse ano). Os discentes, previamente treinados, completaram os certidões de óbito, supervisados por professores de diferentes especialidades, de acordo com o diagnóstico, mediante acesso aos registros médicos dos defuntos. A causa básica de morte assignada após revisão comparou-se com a causa básica originalmente certificada por médicos do hospital, no sistema de registro online em uso na Colômbia: RUAF-ND. Estimou-se a concordância na identificação da causa básica de morte. Obtive-se concordância bruta do 80 % e um acordo de Kappa entre 57 % e 95 %, todos superiores, estatisticamente, a zero, ao agrupar as causas básicas de morte por capítulos da CIE10, com 6 % de códigos inutilizáveis nas duas bases. Este estudo poderia se replicar em outros hospitais universitários e assim fortalecer a capacitação de estudantes de medicina em estatísticas vitais enquanto monitora a qualidade do registro de nascimentos e mortes em hospitais de ensino.
Keywords
vital statistics, birth certificate, death certificate, death cause, Kappa indexestatísticas vitais, certificado de nascimento, certificado de óbito, causa de morte, índice Kappaestadísticas vitales, certificado de nacimiento, certificado de defunción, causa de muerte, índice Kappa
References
1. Presidencia de la República de Colombia. Decreto 1260 de 1970; 1970 [citado 2017 dic. 14]. Disponible en: http://www.alcaldiabogota.gov.co/sisjur/normas/Norma1.jsp?i=8256
2. Presidencia de la República de Colombia. Decreto 1151 de 2000; 2000 [citado 2017 dic. 14]. Disponible en: https://www.dane.gov.co/files/acerca/Normatividad/decreto_1151.pdf
3. Presidencia de la República de Colombia. Decreto 955 de 2002; 2002 [citado 2017 dic. 14]. Disponible en: https://www.minsalud.gov.co/Normatividad_Nuevo/DECRETO%200955%20DE%202002.pdf
4. Constitución Política de Colombia. Artículo 120; 1991 [citado 2017 dic. 14]. Disponible en: http://www.corteconstitucional.gov.co/inicio/Constitucion%20politica%20de%20Colombia%20-%202015.pdf
5. Ministerio de la Protección Social. Circular Externa N.º 000064; 2008 [citado 2017 dic. 14]. Disponible en: https://www.minsalud.gov.co/Normatividad_Nuevo/CIRCULAR%20EXTERNA%20064%20DE%202008.pdf
6. Oficina Sanitaria Panamericana. Certificación médica de causa de defunción. Washington D.C.: Publicaciones Científicas N.o 3; 1953.
7. Pritt B, Hardin NJ, Richmond JA, Shapiro SL. Death certification errors at an academic institution. Arch Pathol Lab Med. 2005;129:1476-9. doi: 10.1043/1543-2165(2005)129[1476:DCEAAA]2.0.CO;2.
8. Rao C, Yang G, Hu J, Ma J, Xia W, Lopez AD. Validation of cause-of-death statistics in urban China. International Journal of Epidemiology. 2007;36:642-51 doi:10.1093/ije/dym003.
9. Aung E, Rao C, Walker S. Teaching cause-of-death certification: lessons from international experience. Postgrad Med J 2010;86:143e152. doi:10.1136/pgmj.2009.089821.
10. Pattaraarchachai1 J, Rao C, Polprasert W, Porapakkham Y, Pao-in W, Noppcha Singwerathum N, Lopez AL. Cause-specific mortality patterns among hospital deaths in Thailand: validating routine death certification. Population Health Metrics. 2010;8:12. Disponible en: http://www.pophealthmetrics.com/content/8/1/12
11. Walker S, Rampatige R, Wainiqolo I, Aumua A. An accessible method for teaching doctors about death certification. Health Inf Manag. 2012;41(1):4-10. doi: 10.1177/183335831204100101.
12. McGivern L, Shulman L, Carney JK, Shapiro S, Bundock E. Death certification errors and the effect on mortality statistics. Public Health Reports 2017;132(6):669-75. doi: 10.1177/0033354917736514.
13. University of Melbourne, Bloomberg Philanthropies Data for Health Initiative. Redefining ‘garbage codes’ for public health policy: Report on the expert group meeting, 27-28 February 2017. CRVS Technical Outcome Series, May 2018. Disponible en: https://crvsgateway.info/file/5253/276.
14. Murray CJL, Lopez AD. Estimating causes of death: new methods and global and regional application for 1990. En: Murray CJL, Lopez AD, editores. Global burden of disease and injury series. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Boston: Harvard School of Public Health, on behalf of the World Health Organization and the World Bank; 1996. p. 117-200.
15. Valdés W, Gutiérrez C, Siura G. Análisis de la calidad de la certificación de defunciones en la región Ica, 2007. Rev Peru Epidemiol. 2013; 17(1):01-07.
16. Soto-Cáceres V. Calidad del llenado de los certificados de defunción en un hospital público de Chiclayo, Perú 2006. Rev Peru Med Exp Salud Publica. 2008;25(3): 330-2.
17. Ribotta B, Escanés G. Códigos “poco útiles” en los registros de defunción en Argentina, Chile, Colombia y México (2000-2011). Revista Electrónica Medicina, Salud y Sociedad. 2014;5(1):4-17. Disponible en: http://cienciasdelasaluduv.com/site/.
18. Rodríguez J, Peñaloza RE, Amaya JL. Estimación de la carga global de enfermedad en Colombia 2012: nuevos aspectos metodológicos. Revista Salud Pública, Universidad Nacional. 2017;19(2): 235-40. doi: 10.15446/rsap.v19n2.66179.
19. Ministerio de Salud y Protección Social. Informe Nacional de Calidad de la Atención en Salud. 2015 [citado 2017 dic. 14]. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/informe-nal-calidad-atencion-salud-2015.pdf
20. DANE. Defunciones por lugar de defunción, 2008-2014. 2017 [citado 2017 dic. 14]. Disponible en: http://systema74.dane.gov.co/bincol/RpWebEngine.exe/Portal?BASE=DEFOC08&lang=esp
21. Bloomberg Data for Health Initiative, University of Melbourne. Enterprise architecture process mapping for strengthening CRVS design. Disponible en: https://crvsgateway.info/file/5140/179
22. Bizagi Process Modeler. Guía de usuario. 2013 [citado 2017 dic.]. Disponible en: http://download.bizagi.com/docs/modeler/2511/es/Modeler_manual_del_usuario.pdf.
23. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global burden of disease study 2010, Lancet. 2012;380:2095-128. doi: 10.1016/S0140-6736(12)61728-0
24. World Health Organisation. International statistical classification of diseases and related health problems, tenth revision, volume 1. Ginebra: WHO; 1993.
25. Cohen J. A coefficient of agreement for nominal scales. Educational and Psychological Measurement. 1960;20:37-46. doi: 10.1177/001316446002000104
26. Cobos D, Abouzahr C, De Savigny D. The ‘Ten CRVS Milestones’ framework for understanding civil registration and vital statistics systems. BMJ Glob Health. 2018;3:e000673. doi:10.1136/bmjgh-2017-000673.
27. Alperovitch A, Bertrand M, Jougla E, Vidal JS, Ducimetiere P, Helmer K, et al. Do we really know the cause of death of the very old? Comparison between oficial mortality statistics and cohort study classification. European Journal of Epidemiology. 2009;24(11): 669-75. doi: 10.1007/s10654-009-9383-2.
28. Halanych JH, Shuaib F, Parmar G, Tanikella R, Howard VJ, Roth DL et al. Agreement on cause of death between proxies, death certificates, and clinician adjudicators in the reasons for geographic and racial differences in stroke (Regards) Study. American Journal of Epidemiology. 2011;173(11). doi: 10.1093/aje/kwr033.
29. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-74. doi: 10.2307/2529310.
30. Abouzahr C, Mikkelsen L, Rampatige R, López A. Mortality statistics: a tool to improve understanding and quality. School of Population Health, University of Queensland, Working Paper Series, Number 13, 2010. Disponible en: https://pdfs.semanticscholar.org/2a8a/fbfe615b248ec8af5e5201dbe909fc8ff0f5.pdf
31. Degani AT, Patel RM, Smith BE, Grimsley E. The effect of student training on accuracy of completion of death certificates. Med Educ. 2009;14:17. doi:10.3885/meo.2009.Res00315.
2. Presidencia de la República de Colombia. Decreto 1151 de 2000; 2000 [citado 2017 dic. 14]. Disponible en: https://www.dane.gov.co/files/acerca/Normatividad/decreto_1151.pdf
3. Presidencia de la República de Colombia. Decreto 955 de 2002; 2002 [citado 2017 dic. 14]. Disponible en: https://www.minsalud.gov.co/Normatividad_Nuevo/DECRETO%200955%20DE%202002.pdf
4. Constitución Política de Colombia. Artículo 120; 1991 [citado 2017 dic. 14]. Disponible en: http://www.corteconstitucional.gov.co/inicio/Constitucion%20politica%20de%20Colombia%20-%202015.pdf
5. Ministerio de la Protección Social. Circular Externa N.º 000064; 2008 [citado 2017 dic. 14]. Disponible en: https://www.minsalud.gov.co/Normatividad_Nuevo/CIRCULAR%20EXTERNA%20064%20DE%202008.pdf
6. Oficina Sanitaria Panamericana. Certificación médica de causa de defunción. Washington D.C.: Publicaciones Científicas N.o 3; 1953.
7. Pritt B, Hardin NJ, Richmond JA, Shapiro SL. Death certification errors at an academic institution. Arch Pathol Lab Med. 2005;129:1476-9. doi: 10.1043/1543-2165(2005)129[1476:DCEAAA]2.0.CO;2.
8. Rao C, Yang G, Hu J, Ma J, Xia W, Lopez AD. Validation of cause-of-death statistics in urban China. International Journal of Epidemiology. 2007;36:642-51 doi:10.1093/ije/dym003.
9. Aung E, Rao C, Walker S. Teaching cause-of-death certification: lessons from international experience. Postgrad Med J 2010;86:143e152. doi:10.1136/pgmj.2009.089821.
10. Pattaraarchachai1 J, Rao C, Polprasert W, Porapakkham Y, Pao-in W, Noppcha Singwerathum N, Lopez AL. Cause-specific mortality patterns among hospital deaths in Thailand: validating routine death certification. Population Health Metrics. 2010;8:12. Disponible en: http://www.pophealthmetrics.com/content/8/1/12
11. Walker S, Rampatige R, Wainiqolo I, Aumua A. An accessible method for teaching doctors about death certification. Health Inf Manag. 2012;41(1):4-10. doi: 10.1177/183335831204100101.
12. McGivern L, Shulman L, Carney JK, Shapiro S, Bundock E. Death certification errors and the effect on mortality statistics. Public Health Reports 2017;132(6):669-75. doi: 10.1177/0033354917736514.
13. University of Melbourne, Bloomberg Philanthropies Data for Health Initiative. Redefining ‘garbage codes’ for public health policy: Report on the expert group meeting, 27-28 February 2017. CRVS Technical Outcome Series, May 2018. Disponible en: https://crvsgateway.info/file/5253/276.
14. Murray CJL, Lopez AD. Estimating causes of death: new methods and global and regional application for 1990. En: Murray CJL, Lopez AD, editores. Global burden of disease and injury series. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Boston: Harvard School of Public Health, on behalf of the World Health Organization and the World Bank; 1996. p. 117-200.
15. Valdés W, Gutiérrez C, Siura G. Análisis de la calidad de la certificación de defunciones en la región Ica, 2007. Rev Peru Epidemiol. 2013; 17(1):01-07.
16. Soto-Cáceres V. Calidad del llenado de los certificados de defunción en un hospital público de Chiclayo, Perú 2006. Rev Peru Med Exp Salud Publica. 2008;25(3): 330-2.
17. Ribotta B, Escanés G. Códigos “poco útiles” en los registros de defunción en Argentina, Chile, Colombia y México (2000-2011). Revista Electrónica Medicina, Salud y Sociedad. 2014;5(1):4-17. Disponible en: http://cienciasdelasaluduv.com/site/.
18. Rodríguez J, Peñaloza RE, Amaya JL. Estimación de la carga global de enfermedad en Colombia 2012: nuevos aspectos metodológicos. Revista Salud Pública, Universidad Nacional. 2017;19(2): 235-40. doi: 10.15446/rsap.v19n2.66179.
19. Ministerio de Salud y Protección Social. Informe Nacional de Calidad de la Atención en Salud. 2015 [citado 2017 dic. 14]. Disponible en: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/informe-nal-calidad-atencion-salud-2015.pdf
20. DANE. Defunciones por lugar de defunción, 2008-2014. 2017 [citado 2017 dic. 14]. Disponible en: http://systema74.dane.gov.co/bincol/RpWebEngine.exe/Portal?BASE=DEFOC08&lang=esp
21. Bloomberg Data for Health Initiative, University of Melbourne. Enterprise architecture process mapping for strengthening CRVS design. Disponible en: https://crvsgateway.info/file/5140/179
22. Bizagi Process Modeler. Guía de usuario. 2013 [citado 2017 dic.]. Disponible en: http://download.bizagi.com/docs/modeler/2511/es/Modeler_manual_del_usuario.pdf.
23. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global burden of disease study 2010, Lancet. 2012;380:2095-128. doi: 10.1016/S0140-6736(12)61728-0
24. World Health Organisation. International statistical classification of diseases and related health problems, tenth revision, volume 1. Ginebra: WHO; 1993.
25. Cohen J. A coefficient of agreement for nominal scales. Educational and Psychological Measurement. 1960;20:37-46. doi: 10.1177/001316446002000104
26. Cobos D, Abouzahr C, De Savigny D. The ‘Ten CRVS Milestones’ framework for understanding civil registration and vital statistics systems. BMJ Glob Health. 2018;3:e000673. doi:10.1136/bmjgh-2017-000673.
27. Alperovitch A, Bertrand M, Jougla E, Vidal JS, Ducimetiere P, Helmer K, et al. Do we really know the cause of death of the very old? Comparison between oficial mortality statistics and cohort study classification. European Journal of Epidemiology. 2009;24(11): 669-75. doi: 10.1007/s10654-009-9383-2.
28. Halanych JH, Shuaib F, Parmar G, Tanikella R, Howard VJ, Roth DL et al. Agreement on cause of death between proxies, death certificates, and clinician adjudicators in the reasons for geographic and racial differences in stroke (Regards) Study. American Journal of Epidemiology. 2011;173(11). doi: 10.1093/aje/kwr033.
29. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-74. doi: 10.2307/2529310.
30. Abouzahr C, Mikkelsen L, Rampatige R, López A. Mortality statistics: a tool to improve understanding and quality. School of Population Health, University of Queensland, Working Paper Series, Number 13, 2010. Disponible en: https://pdfs.semanticscholar.org/2a8a/fbfe615b248ec8af5e5201dbe909fc8ff0f5.pdf
31. Degani AT, Patel RM, Smith BE, Grimsley E. The effect of student training on accuracy of completion of death certificates. Med Educ. 2009;14:17. doi:10.3885/meo.2009.Res00315.
Como Citar
Rodríguez García, J., Vega Landaeta, A. P., Jaramillo, L. F., Fernández Ortiz, Y., Suarez Morales, Z. B., & Vásquez Candia, M. E. (2019). Qualidade na certificação de mortalidade e natalidade em um hospital universitário, Colômbia ano 2014. Gerencia Y Políticas De Salud, 18(36), 1–42. https://doi.org/10.11144/Javeriana.rgsp18-36.ccmn
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