Sistema de Informação de Mortalidade nos Municípios do Estado de São Paulo: análise situacional

Abstract

 Introduction: Mortality Information System (MIS) is an important tool and can be applied for the      population health analisys, to support for the management and planning of interventions in healthcare.      With the implementation of the Unified Health System (SUS), new assignments were initiated on      the municipalities, such as organizing and coordinating health information systems, as the use of      epidemiology to establish priorities. Objective: to describe the MIS decentralization in the counties      based on 6 dimensions: professional profile, physical structure, technical training, work process,      system management, dissemination of data, difficulties and benefits of decentralization. Methods:      electronic questionnaire was applied to 645 technical experts in each municipality. The municipalities      were grouped by population size: Group 1, ≤30,000; Group 2, 30,001-200,000 and Group 3, >200,000      inhabitants. Data analysis used descriptive statistics, with distribution and measures of central tendency.      Chi-square test and A NOVA were used to compare proportions and averages, respectively, between      groups. Results: 584 municipalities responded (90.5%), 91.0% of Group 1, 88.7% of Group 2 and      92.5% of Group 3. The predominant profile of responsible technicians for all groups were: female ,      mean age 39.3 years, college education, nurse, and permanent employed with more than three years      work on the MIS. In Group 1 the MIS was allocated in Epidemiologic Surveillance service, the team      has 1 professional, the structure has 1 computer with older operating system, received training about      the system, 30% carry out active search for underreported deaths , do not use reports from the system      and has difficulty in codifying the causes of death, data is used by the Primary Care and indicate that      decentralization brings many benefits. In Group 2 the MIS is also allocated to the Epidemiological      Surveillance, their teams have 2-3 professionals, have a computer with new operating system version,      received training about the system, review of blank fields on the death certificate, use reports from the      system and has difficulty in codifying the cause of death. The data are used by the Maternal and Infant      Death Investigation Committee for planning and agreement, and indicate little benefit in attracting      information of deaths outside the municipality. In Group 3, the MIS is allocated in Information Sector,      have teams with 2-5 professionals, 2 computers, new computer operating system installed, qualified      professionals, areas that used the data are Action Planning and Secretary Health , present few difficulties      and point out the many benefits the system decentralization. Conclusion: The MIS is widely used in      the counties and consolidated in Group 3, but problems remain for the adequate system operation and      coding of cause death in Group 1 and 2. We recommend more attention from the regional and state level      to these issues management and professional training