[Obstetrical inpatient care and hospitalization risks in hospitals of Brazil].
OBJECTIVE
To analyze variations in early neonatal mortality, stillbirth rates, and a set of indicators collected from obstetric hospitals affiliated to the Brazilian National Unified Health System (SUS) for their monitoring through the Hospital Data System (SIH/SUS) and Live Births Data System (SINASC).


METHODS
One-hundred and thirty five hospitals in the state of Rio de Janeiro were assessed in 1997. Factor analysis was conducted using principal components. Score distribution for the first two components were established, which allowed to classify hospitals according to maternal risk profile and care outcomes.


RESULTS
Hospitals affiliated to SUS were responsible for 77.8% of all deliveries in the state of Rio de Janeiro and 23% of them performed fewer than 100 deliveries a year. Among hospitals of extreme high maternal risk and low performance, there were several units considered as referral centers for high-risk pregnancy. It was also observed that 5% of hospital units with low complexity infrastructures showed a profile of high maternal risk and questionable care outcomes.


CONCLUSIONS
The Hospital Information Data System affiliated to the National Unified Health System has proven to be an important information source for monitoring hospital stillbirth and early neonatal mortality rates as well as for planning surveillance actions for health services providing obstetric and/or neonatal care.
Schramm
Joyce M A
JM
Departamento de Epidemiologia e Métodos Quantitativos, Escola Nacional de Saúde Publica, Fundação Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. joyce@ensp.fiocruz.br
Szwarcwald
Célia L
CL
Esteves
Maria A P
MA
D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003695:Delivery of Health Care / Q000592:standards; D005163:Factor Analysis, Statistical; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006301:Health Services Needs and Demand; D006751:Hospital Information Systems; D006760:Hospitalization; D006771:Hospitals, Maternity / Q000592:standards*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011787:Quality of Health Care; D012306:Risk