Brazilian Data Sources
For the present version of the Cardiovascular Statistics - Brazil document, the main Brazilian data sources were the Brazilian Mortality and Hospital Information Systems, periodic health surveys, such as the National Health Survey, and official population estimates.
Brazilian Mortality Information System: In Brazil, the SIM, created in 1975 by the Brazilian Ministry of Health, is responsible for collecting, storing, managing, and disseminating national mortality data. This health information system represented a major advance in the country's epidemiological surveillance, since its main task is to record all deaths occurring in the Brazilian territory. The Brazilian Ministry of Health implemented a Standard Certificate of Death model, a document for collecting information on death, that uses the ICD to code the causes of death. In addition, a flow of collection, processing, and distribution of death information has been implemented in all 5570 municipalities across the country.¹,² The quality of statistics on causes of death in Brazil significantly improved in the last two decades, but data from the beginning of the 2000 decade are still of low quality, specifically in some parts of the country.³ Knowing the heterogeneity of these indicators in Brazil, the Brazilian Cardiovascular Statistics report treated data to estimate information closer to real, by correcting for underreporting and redistribution of ill-defined causes of death. More details can be found in the article by Malta et al.⁴
Brazilian Hospital Information System: The aim of the SIH database is to register all hospitalizations funded by the SUS. The SIH-SUS compiles the hospitalizations at the municipal level through the “Hospital Admission Authorization”, which has information about the diseases leading to hospitalization (using ICD-10), length of stay, procedures, and costs.⁵ The SIH-SUS information allows the development of methodologies and the definition of indicators to identify geographical disparities related to hospital resources.⁶
National Health Survey: When the statistics for CV risk factors are cited, a preference for the PNS survey was made. The PNS is a household-based epidemiological survey, representative of Brazil, its large regions, FUs, metropolitan regions, capitals, and other municipalities in each FU. The PNS 2013 sample was composed of 64 348 households. The survey was carried out by the IBGE in partnership with the Ministry of Health. Most health topics were included, such as noncommunicable diseases, risk factors, elderly, women, children, use of health services, health inequalities, anthropometric features, laboratory tests, and blood pressure measurements.⁷ The PNS data are used by the GBD in its estimates for Brazil.
For population estimates, the most updated population estimates generated by the IBGE (www.ibge.gov.br) were used in the denominator. For the hospitalizations and cost analyses, the resident population estimated for the National Audit Office yearly, from 2008 to 2019, was used.
1. Brasil. Ministério da Saúde. Manual de Instruções para o Preenchimento da Declaração de Óbito. Brasília: Ministério da Saúde; 2011.
2. Jorge MH, Laurenti R, Gotlieb SL. Análise da Qualidade das Estatísticas Vitais Brasileiras: A Experiência de Implantação do SIM e do SINASC. Cien Saude Colet. 2007;12(3):643-54. doi: 10.1590/s1413-81232007000300014.
3. França E, Abreu DX, Rao C, Lopez AD. Evaluation of Cause-of-Death Statistics for Brazil, 2002-2004. Int J Epidemiol. 2008;37(4):891-901. doi: 10.1093/ije/dyn121.
4. Malta DC, Teixeira R, Oliveira GMM, Ribeiro ALP. Cardiovascular Disease Mortality According to the Brazilian Information System on Mortality and the Global Burden of Disease Study Estimates in Brazil, 2000-2017. Arq Bras Cardiol. 2020;115(2):152-160. doi: 10.36660/abc.20190867.
5. Escosteguy CC, Portela MC, Medronho RA, Vasconcellos MT. O Sistema de Informações Hospitalares e a Assistência ao Infarto Agudo do Miocárdio. Rev Saude Publica. 2002;36(4):491-9. doi: 10.1590/s0034-89102002000400016.
6. Rocha TAH, Silva NCD, Amaral PVM, Barbosa ACQ, Vissoci JRN, Thomaz EBAF, Queiroz RCS, Harris M, Facchini LA. Geolocation of Hospitalizations Registered on the Brazilian National Health System's Hospital Information System: A Solution Based on the R Statistical Software. Epidemiol Serv Saude. 2018;27(4):e2017444. doi: 10.5123/S1679-49742018000400016.
7. Malta DC, Stopa SR, Szwarcwald CL, Gomes NL, Silva JB Jr, Reis AA. Surveillance and Monitoring of Major Chronic Diseases in Brazil - National Health Survey, 2013. Rev Bras Epidemiol. 2015;18(Suppl 2):3-16. doi: 10.1590/1980-5497201500060002.