Lopakov K.V.
Federal Public Health Institute, Moscow

The resume. Aim of this study: to reveal the defects in coding the causes of death.

Materials and Methods: The pilot study investigated into causes of death as they were formulated in medical Certificates of Death in Kaluga Region in 2002. 19,633 Certificates were successively processed for search of age and gender demography of mortality in this Region. At the 2^nd stage, a selective survey was performed for more detailed analysis of quality of coding of causes of death for verification motive. 419 Certificates of Death were selected to this end which constitute 2% of the whole pool of registry. This selection was representative of the Kaluga Region as to age, gender and causes of death existing here in the cohort of 30-75 year old subjects.

Results: The defects of medical documentation could be divided into following categories:

1. Inaccurate transfer of the data of Certificates of Death into the electronic data bases. Most frequently it concerns point 16. of this Form which says: The one who established the cause of death. Most frequently, a physician that assessed the fact of death was indicated here. As a result, the number of dubious diagnoses of death elevated threefold from the original situation.

2. Obviously insufficiently qualified staff person to testify the cause of death.

3. Insufficient evidence to testify the cause of death (when it had been made on the unique basis of either examination of the cadaver, or prior to death medical documentation/prior to death observation), it was revealed in half the cases.

4. High rate of “unspecified” or “other” causes, even when it concerned a statistically significant, if not mass death situation (one third to three quarters of the cases).

All real conclusions of this study were obtained from selected 2% (30-75 years old persons) of all included Death Certificates, nevertheless these notions are quite viable and they could readily be extrapolated on all the Districts of RF where mortality rate differs from the studied Kaluga Region within the range of 10-26%, and where geriatric mortality (60-74 years old persons) is nearly average to all the country.

Key words: mortality, medical certificate of death, unspecified diagnoses of death, defects of coding for registry of death.

References

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