Integrating Brazilian health information systems in order to support the building of data warehouses

Freire, Sergio Miranda; Souza, Rômulo Cristovão de; Almeida, Rosimary Terezinha de

doi:10.1590/2446-4740.0666

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Research on Biomedical Engineering

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Sumário

Original articles • Res. Biomed. Eng. 31 (3) • Jul-Sep 2015 • https://doi.org/10.1590/2446-4740.0666 copy

Integrating Brazilian health information systems in order to support the building of data warehouses

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

This paper's aim is to develop a data warehouse from the integration of the files of three Brazilian health information systems concerned with the production of ambulatory and hospital procedures for cancer care, and cancer mortality. These systems do not have a unique patient identification, which makes their integration difficult even within a single system.

Methods

Data from the Brazilian Public Hospital Information System (SIH-SUS), the Oncology Module for the Outpatient Information System (APAC-ONCO) and the Mortality Information System (SIM) for the State of Rio de Janeiro, in the period from January 2000 to December 2004 were used. Each of the systems has the monthly data production compiled in dbase files (dbf). All the files pertaining to the same system were then read into a corresponding table in a MySQL Server 5.1. The SIH-SUS and APAC-ONCO tables were linked internally and with one another through record linkage methods. The APAC-ONCO table was linked to the SIM table. Afterwards a data warehouse was built using Pentaho and the MySQL database management system.

Results

The sensitivities and specificities of the linkage processes were above 95% and close to 100% respectively. The data warehouse provided several analytical views that are accessed through the Pentaho Schema Workbench.

Conclusion

This study presented a proposal for the integration of Brazilian Health Systems to support the building of data warehouses and provide information beyond those currently available with the individual systems.

Keywords
Record linkage; Health information systems; Database integration; Data warehouse; Neoplasms

Variable	apac		aih
Variable	m_i	u_i	m_i	u_i
Year of Birth	0.92	0.018	0.956	0.016
Month of Birth	0.94	0.084	0.981	0.084
Day of Birth	0.91	0.033	0.971	0.034
Patient’s Middle Initials	0.83	0.042	0.998	0.038
Patient’s first name	0.92	0.029	0.954	0.0081
Patient’s last name	0.93	0.021	0.990	0.034
Patient’s middle name	0.9	0.008	0.970	0.009
Mother’s first name	0.89	0.049	-	-
Mother’s second name	0.9	0.008	-	-
Mother’s last name	0.91	0.021	-	-
Mother’s middle Initials	0.83	0.083	-	-
Gender	-	-	0.992	0.564
Address	-	-	0.719	0.00054
Individual taxpayer number	-	-	0.26	0.00001
Medical Record Number	-	-	0.775	0.00010

Number of records	Number of Patients
Number of records	apac	aih
1	6,931	1,793,054
2	9,266	401,112
3	6,846	127,636
4	3,088	56,629
5	2,918	27,591
6	3,100	16,568
7	1,765	9,892
8	2,024	6,604
9	1,393	4,680
10	1,160	3,398
>10	14,944	23,836
Total	53,435	2,471,000

	apac	aih	apac-aih	apac-sim
Link	Yes	No	Yes	No	Yes	No	Yes	No
T⁺	3396	0	2906	0	8908	0	1184	0
T^-	2	3905	5	4778	55	17515	43	987
Total	3398	3905	2911	4778	8963	17515	1227	987
Sensitivity (95% CI)	99.94 (99.79; 99.98)		99.83 (99.6; 99.93)		99.39 (99.2; 99.53)		96.50 (95.31; 97.39)
Specificity (95% CI)	100 (99.9; 100)		100 (99.92; 100)		100 (99.98; 100)		100 (99.61; 100)

Group	Metrics	Dimensions
Patients	Number of patients Number of cases of cancer Average age Number of deaths Percentage of deaths	Gender Age group Place of residence
Cases of Cancer	Number of cases Number of new cases Diagnosis-treatment interval Number of deaths Average age Diagnosis-death interval Percentage of deaths	Year Type of cancer Age group Gender Staging Metastasis Place of residence Provider
Outpatient services	Number requested procedures Number approved procedures Number irradiated fields Charged value Reimbursed value Average charged value	Year Treatment modality Provider Reason for discharge
Hospital admissions	Number of patients	Year Hospital Diagnosis on admission Reason for discharge Link to APAC

Sociedade Brasileira de Engenharia Biomédica Centro de Tecnologia, bloco H, sala 327 - Cidade Universitária, 21941-914 Rio de Janeiro RJ Brasil, Tel./Fax: (55 21)2562-8591 - Rio de Janeiro - RJ - Brazil
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