T.P. Sabgayda¹, V.G. Semyonova¹, G.N. Evdokushkina¹, Ye.M. Sekrieru¹, S.Yu. Nikitina^2
1Federal Research Institute for Health Organization and Informatics of Ministry of Health of Russian Federation, Moscow
²Federal State Statistics Service, Moscow, Russia

Abstract. Relevance of the work is determined by the need to improve the reliability of mortality statistics to assess the real demographic situation.

Aim: To analyze compliance with the rules of modification of underlying death causes.

Methods. Information from the impersonal death register of 2011 was analyzed in regard to cancers, endocrine diseases, mental disorders and diseases of the nervous system.

We used only that data from the register which describes the lethal process using three death codes and where code of the underlying death cause did not coincide with the final diagnosis of the death cause.

Results. The use of malignant neoplasms as a prior death cause as well as the use of C97 code as the underlying death cause were identified, though it is prohibited by the rules of coding. The rules for determining the fourth digit in the code of the underlying death cause for diabetes were violated in 63.8% of cases. Incorrect modification of the underlying death cause from diseases of the nervous system was identified in 78.3% of cases.

Causes F10-F19 (Mental and behavioral disorders due to psychoactive substance use) constitute 78.7% in the "Mental and behavioral disorders" class. Among them, 45.7% of cases required modification of the underlying death cause.

Failure to comply with the rules of modification of causes of death from diseases of the nervous system and mental illness leads to under-diagnosis of mortality from cardiovascular disease.

Conclusions. Russian specialists are often not familiar with the rules of coding of death causes resulting in distorted mortality structure. We can assume that formalization of medical information using a classifier is alien to medical specialists per se.

Keywords. Quality coding of causes of death, ICD-X; mortality statistics; death certificates; selection of underlying death cause; modification of underlying cause of death; the accuracy of death cause diagnosis

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