Abstract
To describe the construction and testing of a routine to assess psychiatric hospitalizations in the Brazilian Health System based on its database (DATASUS), and to assess characteristics and trends of these hospitalizations. Data were extracted from hospital admission authorizations in the state of Rio Grande do Sul, Southern Brazil, from 2000 to 2004. Data from 91,233 admissions were processed through a routine (syntaxes) using SPSS program and their reliability was tested. Hospitalization rates in general and psychiatric hospitals and main diagnoses were described, and trends were analyzed using polynomial regression models. Intra and inter-rater reliabilities were 100%. There was seen a trend of increasing hospitalization rates due to mood disorders and decreasing rates due to schizophrenia and organic disorders. Hospitalization rates due to substance use disorders remained stable. There was an increasing trend in the number of psychiatric hospitalizations in general hospitals with a 97.7% growth in the period studied. Routines proved to be reliable and feasible, suggesting the use of data from Hospital Information System database as a source of information for continuous evaluation of psychiatric hospitalizations in Brazilian Health System. Psychiatric hospitalization rates may have changed due to changes in the type of patients; diagnostic patterns, known as treatment-oriented diagnostic bias; and legislation.
Highlights
The Brazilian policy on mental health has undergone important changes since the country signed the Caracas Declaration, the main purpose of which was to direct mental health legislation towards the deinstitutionalization of psychiatric patients
There was seen a trend of increasing hospitalization rates due to mood disorders and decreasing rates due to schizophrenia and organic disorders
Files in the “.dbc” format, containing all AIHs organized by month and state were located
Summary
The Brazilian policy on mental health has undergone important changes since the country signed the Caracas Declaration, the main purpose of which was to direct mental health legislation towards the deinstitutionalization of psychiatric patients. The last decade has seen a major advancement in the accessibility of information through the Internet by means of the Sistema de Informação Hospitalar (SIH/SUS – Hospital Information System). This database, originally intended for administrative purposes, contains data on all hospitalizations paid for by SUS in Brazil. It can be consulted through the DATASUS website,** as part of the universal accessibility policy of the Brazilian public health care system, which has been extended to administrative data. This file includes patient diagnosis, selected demographic information, place and date of admission, length of stay, and hospitalization costs
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