Códigos garbage declarados como causas de morte nas estatísticas de saúde

Abstract

Approximately 1.3 million deaths occur in Brazil every year. Of these, more than 600,000 are premature deaths of people under 70 years old, mostly due to cardiovascu-lar diseases, violence or accidents, and neoplasms 1 ; many of them avoidable. Given this context, how can accurate and timely information be obtained about deaths and their causes? Evaluating the quality of information on causes of death is essential for the decision process on how to implement the necessary health interventions 2. Brazil stands out in this respect due to the advances achieved with the creation of nationwide health information systems 3. The Mortality Information System (SIM) is an example of this advance as it has recorded more than 95% of estimated deaths between 2000-2010 4. The quality of statistics on causes of death is, however, questionable since approximately 400,000 deaths with causes classified as garbage codes (GC) 1 are recorded in the SIM annu-aly. This term refers to a concept introduced in the first Global Burden of Disease Study (GBD) 5 for causes that should not be considered as the underlying cause of death or are non-specific, therefore considered insufficient concerning prevention. Septicemia and heart failure, for example, may stem from different pathologies and are, however, classified at the highest GC level of severity considering the potential impact on the development of public policies used in the prevention of premature deaths 6. According to the GBD study method, all GCs should be redistributed to specific causes, in accordance with defined algorithms 7.8. Which initiatives could be taking in tackling this problem in Brazil? In 2016, the Ministry of Health (MoH) proposed four priority interventions aimed at improving information on causes of death as part of the Bloomberg Philanthropies Data for Health Initiative (D4H) project, of which Brazil was one of the 20 invited countries. Among the proposed interventions, the investigation of GC cases registered in the SIM in 2017 and the training of physicians in the correct completion of death certificates were prioritized.