T.P. Sabgayda1, V.G. Semyonova1, G.N. Evdokushkina1, Ye.M. Sekrieru1, S.Yu. Nikitina2
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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