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Main arrow Archive of previous Issues arrow ╣2 2011 (18) arrow Evaluation of confidence for coded causes of death: a pilot study
Evaluation of confidence for coded causes of death: a pilot study Print
Thursday, 02 June 2011

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 2nd 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 ôunspecifiedö or ôotherö 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

  1. Vaysman DA, Dubrovina EV, Redko AN. Informatsionnoye obespecheniye issledovaniy po problemam smertnosti v Rossii [Information sources for studies of problems of mortality in Russia]. Obshchestvennoe zdorove i profilaktika zabolevaniy 2006;(6):31-38.
  2. Pogorelova EI. Sistema meropriyatiy po povysheniyu dostovernosti statistiki smertnosti naseleniya [Systemic measures to improve verification and confidence in the statistics of population mortality]. Problemy sotsialnoy gigieny, zdravookhraneniya i istorii meditsiny 2006;(2):45-49
  3. Pogorelova EI. Ob oshibkakh pri zapolnenii meditsinskogo svidetelstva o smerti [On systemic mistakes in completing medical certificate of death]. Problemy sotsialnoy gigieny, zdravookhraneniya i istorii meditsiny 2007;(1):43-47
  4. Sekrieru EM, Pogorelova EI, Vaysman DA, Nikitin SV, Khromushin VA. Povysheniye dostovernosti kodirovaniya vneshnikh prichin smerti [To improve verification and confidence rate in coding the external causes of death]. Tula: Vestnik NMT 2006;(12):147-148.
  5. Sekrieru EM, Pogorelova EI. Razrabotka sistemy meropriyatiy dlya sovershenstvovaniya ispolzovaniya statisticheskikh dannykh o smertnosti naseleniya Rossiyskoy Federatsii. Zaklyuchitelnyy nauchnyy doklad [Development of comprehensive measures to facilitate the engagement of statistical data on population mortality in the Russian Federation]. Moscow; TsNIIOIZ MZ RF; 2003. p. 34
  6. Pogorelova EI, Khromushin VA, Sekrieru EM. Vozmozhnosti dopolnitelnogo povysheniya dostovernosti dannykh po smertnosti naseleniya [Additional possibilities to improve verification and confidence rate in the statistics of population mortality]. Tula: Vestnik NMT 2005;(2):96-96.
  7. Semyonova VG, Gavrilova NS, Evdokushkina GN, Gavrilov LA. Kachestvo mediko-statisticheskikh dannykh kak problema sovremennogo rossiyskogo zdravookhraneniya [Quality of medical statistical data as a current problem of Russian public health]. Obshchestvennoe zdorove i profilaktika zabolevaniy 2004;(2):11-19.

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