MEDICAL CERTIFICATION OF CAUSE OF DEATH.

The Lancet ◽  
1924 ◽  
Vol 204 (5272) ◽  
pp. 570-571
Keyword(s):  
Cause Of Death ◽  
Medical Certification

scholarly journals Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
John D. Hart ◽  
Renee Sorchik ◽  
Khin Sandar Bo ◽  
Hafizur R. Chowdhury ◽  
Saman Gamage ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Effective Strategies ◽  
Health Initiative ◽  
Medical Certification

scholarly journals India’s Civil Registration System: a potentially viable data source for reliable subnational mortality measurement

2020 ◽  
Author(s):  
Chalapati Rao ◽  
Mamta Kansal
Keyword(s):  
Cause Of Death ◽  
Civil Registration System ◽  
Registration System ◽  
Civil Registration ◽  
Medical Certification ◽  
Sample Registration System ◽  
Reliable Source ◽  
Data Source ◽  
Near Future

ABSTRACTIntroductionThe Indian national Civil Registration System (CRS) is the optimal data source for mortality measurement, but is yet under development. As an alternative, data from the Sample Registration System (SRS) which covers less than 1% of the national population is used. This article presents a comparative analysis of mortality measures from the SRS and CRS in 2017, and explores the potential of the CRS to meet these subnational data needs.MethodsData on population and deaths by age and sex for 2017 from each source were used to compute national and state level life tables. Sex specific ratios of death probabilities in five age categories (0-4, 5-14, 15-29, 30-69, 70 -84, 85+) were used to evaluate CRS data completeness, using SRS probabilities as reference values. The quality of medically certified causes of death was assessed through hospital reporting coverage and proportions of deaths registered with ill-defined causes from each state.ResultsThe CRS operates through an extensive infrastructure with high reporting coverage, but child deaths are uniformly under reported, as well as female deaths in some states. However, at ages 30 to 69 years, CRS death probabilities are higher than the SRS values in 15 states in males and 10 states in females. SRS death probabilities are of limited precision for measuring mortality trends and differentials. Medical certification of cause of death is affected by low hospital reporting coverage.ConclusionsThe Indian CRS is more reliable than the SRS for measuring adult mortality in several states. Targeted initiatives to improve the recording of child and female deaths, to strengthen the quality of medical certification of cause of death, and to promote use of verbal autopsy methods are necessary to establish the CRS as a reliable source of sub national mortality statistics in the near future.KEY MESSAGESThe Sample Registration System (SRS) is currently the main source of mortality statistics in India, since the Civil Registration System (CRS) is yet under developmentLimitations in sample size as well as problems with quality of causes of death result in considerable uncertainty in population level mortality estimates from the SRSThis research evaluated the quality of the sex and age specific mortality risks from the CRS, using the SRS values in each state as reference valuesThe CRS has high levels of reporting coverage for death registration, and also measures higher levels of mortality at ages 30 to 69 years in several states, with high precisionInterventions are required to improve child death registration, strengthen medical certification of cause of death in hospitals, and introduce verbal autopsy for home deathsThese interventions will establish the CRS as a routine and reliable source for national and subnational mortality measurement in India in the near future

scholarly journals The impact of errors in medical certification on the accuracy of the underlying cause of death

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259667
Author(s):  
U. S. H. Gamage ◽  
Tim Adair ◽  
Lene Mikkelsen ◽  
Pasyodun Koralage Buddhika Mahesh ◽  
John Hart ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Death Certificate ◽  
International Classification Of Diseases ◽  
High Impact ◽  
Error Type ◽  
Medical Certification ◽  
Underlying Cause Of Death ◽  
The Impact ◽  
Very High ◽  
Death Data

Background Correct certification of cause of death by physicians (i.e. completing the medical certificate of cause of death or MCCOD) and correct coding according to International Classification of Diseases (ICD) rules are essential to produce quality mortality statistics to inform health policy. Despite clear guidelines, errors in medical certification are common. This study objectively measures the impact of different medical certification errors upon the selection of the underlying cause of death. Methods A sample of 1592 error-free MCCODs were selected from the 2017 United States multiple cause of death data. The ten most common types of errors in completing the MCCOD (according to published studies) were individually simulated on the error-free MCCODs. After each simulation, the MCCODs were coded using Iris automated mortality coding software. Chance-corrected concordance (CCC) was used to measure the impact of certification errors on the underlying cause of death. Weights for each error type and Socio-demographic Index (SDI) group (representing different mortality conditions) were calculated from the CCC and categorised (very high, high, medium and low) to describe their effect on cause of death accuracy. Findings The only very high impact error type was reporting an ill-defined condition as the underlying cause of death. High impact errors were found to be reporting competing causes in Part 1 [of the death certificate] and illegibility, with medium impact errors being reporting underlying cause in Part 2 [of the death certificate], incorrect or absent time intervals and reporting contributory causes in Part 1, and low impact errors comprising multiple causes per line and incorrect sequence. There was only small difference in error importance between SDI groups. Conclusions Reporting an ill-defined condition as the underlying cause of death can seriously affect the coding outcome, while other certification errors were mitigated through the correct application of mortality coding rules. Training of physicians in not reporting ill-defined conditions on the MCCOD and mortality coders in correct coding practices and using Iris should be important components of national strategies to improve cause of death data quality.

Medical certification of cause of death

1991 ◽  
pp. 13-22
Author(s):  
Jennifer Green ◽  
Michael Green
Keyword(s):  
Cause Of Death ◽  
Medical Certification

scholarly journals Improving quality of medical certification of causes of death in health facilities in Tanzania 2014–2019

2021 ◽  
Vol 21 (S1) ◽  
Author(s):  
Trust Nyondo ◽  
Gisbert Msigwa ◽  
Daniel Cobos ◽  
Gregory Kabadi ◽  
Tumaniel Macha ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Policy ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Health Facilities ◽  
Mortality Data ◽  
Medical Certification ◽  
Specific Mortality ◽  
Icd 10

Abstract Background Monitoring medically certified causes of death is essential to shape national health policies, track progress to Sustainable Development Goals, and gauge responses to epidemic and pandemic disease. The combination of electronic health information systems with new methods for data quality monitoring can facilitate quality assessments and help target quality improvement. Since 2015, Tanzania has been upgrading its Civil Registration and Vital Statistics system including efforts to improve the availability and quality of mortality data. Methods We used a computer application (ANACONDA v4.01) to assess the quality of medical certification of cause of death (MCCD) and ICD-10 coding for the underlying cause of death for 155,461 deaths from health facilities from 2014 to 2018. From 2018 to 2019, we continued quality analysis for 2690 deaths in one large administrative region 9 months before, and 9 months following MCCD quality improvement interventions. Interventions addressed governance, training, process, and practice. We assessed changes in the levels, distributions, and nature of unusable and insufficiently specified codes, and how these influenced estimates of the leading causes of death. Results 9.7% of expected annual deaths in Tanzania obtained a medically certified cause of death. Of these, 52% of MCCD ICD-10 codes were usable for health policy and planning, with no significant improvement over 5 years. Of certified deaths, 25% had unusable codes, 17% had insufficiently specified codes, and 6% were undetermined causes. Comparing the before and after intervention periods in one Region, codes usable for public health policy purposes improved from 48 to 65% within 1 year and the resulting distortions in the top twenty cause-specific mortality fractions due to unusable causes reduced from 27.4 to 13.5%. Conclusion Data from less than 5% of annual deaths in Tanzania are usable for informing policy. For deaths with medical certification, errors were prevalent in almost half. This constrains capacity to monitor the 15 SDG indicators that require cause-specific mortality. Sustainable quality assurance mechanisms and interventions can result in rapid improvements in the quality of medically certified causes of death. ANACONDA provides an effective means for evaluation of such changes and helps target interventions to remaining weaknesses.

scholarly journals Addressing the rising cause of death due to diseases of the circulatory system geared towards achieving SDG 3: evidence from data on medical certification of cause of deaths in Rajasthan State, India: 1999-2015

2017 ◽  
Vol 5 (1) ◽  
pp. 182 ◽  
Author(s):  
Manoj Kumar Raut ◽  
Ananta Basudev Sahu
Keyword(s):  
Cause Of Death ◽  
Estimation Method ◽  
Well Being ◽  
Chronic Respiratory Disease ◽  
Civil Registration System ◽  
Registration System ◽  
Civil Registration ◽  
Medical Certification ◽  
Cause Of Deaths ◽  
Circulatory Diseases

Background: Medical certification of cause of death (MCCD) scheme is imperative tool to obtain scientific and reliable information in terms causes of mortality. The office of the registrar general of India (ORGI) initiated the scheme on MCCD under civil registration system (CRS), during the third five year plan. Methods: This paper analyzes the data for the last 16 years for MCCD in Rajasthan from 1999 to 2015. The findings are based on more than half a million deaths, for which cause of death data is reported. The per cent of cause of deaths have been computed and the curve estimation method has been used to project the cause of death due to circulatory diseases. Results: The data reveals that the percentage of medically certified deaths hovers around 10 to 13 percent during 1999 to 2015 of the total deaths registered under the civil registration system, which is about 5 million deaths. The highest percentage of deaths that has been medically certified is due to circulatory diseases as seen for the combined period of sixteen years (1999-2015) (21 percent) followed by deaths due to certain infectious and parasitic diseases (16 percent). This has increased from 13.8 per cent in 1999 to 20.2 per cent in 2015. This proportion has been projected upto 2030, the target year of achievement of Sustainable Development Goals (SDGs). Conclusions: Addressing this cause, could help in the achievement of indicator of 3.4.1, mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease under the target of reducing by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being by 2030 subsumed under the SDG 3 of ensuring healthy lives and promote well-being for all at all ages. 

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