The Role of Dementia as Cause of Death: Certifiers’ Opinions versus Automated Coding

2020 ◽  
pp. 1-7
Author(s):  
Peter Harteloh
Keyword(s):  
Cause Of Death ◽  
Death Certificate ◽  
Sudden Change ◽  
International Comparisons ◽  
Coding System ◽  
Policy Makers ◽  
Automated Coding ◽  
Icd 10 ◽  
Underlying Cause Of Death

<b><i>Background:</i></b> Dementia is a major cause of death in many countries today. The way in which countries code causes of death determines the occurrence of dementia in statistics. The change over from manual to automated coding is accompanied by a 7–19% increase in the occurrence of dementia as the underlying cause of death. Because of this sudden change, researchers, physicians, policy makers, and press question the validity of the outcome of automated coding. Therefore, the role of dementia as a cause of death was investigated. <b><i>Methods:</i></b> A questionnaire was sent to a random sample of 700 certifiers who mentioned “dementia” on a death certificate in the second half of 2017. They were asked questions about the role of dementia as a cause of death. For each certificate, the opinion of the certifier was compared with the outcome of automated coding. <b><i>Results:</i></b> A response of 65% (<i>n</i> = 446) was obtained. The automated coding system selected dementia as the underlying cause of death 9.5% points (95% CI: 5.8–14.4%) more often than the certifier would do. This finding in the sample corresponded to an overestimation of dementia in the cause-of-death statistics with 22.7% (95% CI: 18–28%). Main reason for this overestimation was the selection of dementia as the underlying cause of death by the automated coding system, while it was noted as the contributory cause of death on part 2 of the death certificate by the certifier. <b><i>Conclusion:</i></b> For international comparisons of data on dementia as a cause of death, the outcome of automated coding can be used as the system adheres to international (ICD-10) guidelines and reduces coding variations in and between countries. However, for interpreting the local (national) impact of dementia as a cause of death, the opinion of the certifier should be taken into account.

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.

scholarly journals 531Investigating systemic autoimmune diseases as a group of causes of death: mortality burden and comorbidities

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Marianna Mitratza ◽  
Bart Klijs ◽  
A Elisabeth Hak ◽  
Jan WPF Kardaun ◽  
Anton E Kunst
Keyword(s):  
Mortality Rate ◽  
Autoimmune Diseases ◽  
Causes Of Death ◽  
Death Certificate ◽  
Subcutaneous Tissue ◽  
Classification Systems ◽  
Systemic Autoimmune Diseases ◽  
Mortality Burden ◽  
Icd 10 ◽  
Underlying Cause Of Death

Abstract Background Systemic autoimmune diseases (SAIDs) have chronic trajectories and share characteristics of self-directed inflammation and aspects of clinical expression. Nonetheless, burden-of-disease studies rarely investigate them as a distinct category. This study aims to assess the mortality rate of SAIDs as a group and to evaluate co-occurring causes of death. Methods We used death certificate data in the Netherlands, 2013-2017, (N = 711,247) and constructed a SAIDs list (4-position ICD-10). The mortality rate of SAIDs as underlying Cause of Death (CoD), non-underlying CoD, and any-mention CoD was calculated. We estimated age-sex-standardized observed/expected ratios to assess comorbidities in deaths with SAID relative to the general deceased population. Results We observed 3,335 deaths with SAID on their death certificate (0.47% of all deaths). The mortality rate of SAID was 14.6 per million population as underlying CoD, 28.0 as non-underlying CoD, and 39.7 as any-mention CoD. The mortality rate was higher for females and increased exponentially with age. SAID-related deaths were positively associated with all comorbidities except for solid neoplasms and mental conditions. Particularly strong was the association with musculoskeletal (O/E=3.38,95% CI[2.98,3.82]), other genitourinary (O/E=2.73,95% CI[2.18,3.38]), blood (O/E=2.02,95% CI[1.70,2.39]), skin and subcutaneous tissue (O/E=1.95,95% CI[1.54,2.45]), and infectious diseases (O/E=1.85,95% CI[1.70,2.01]), as well as influenza (O/E=2.71,95% CI[1.74,4.03]). Conclusions Systemic autoimmune diseases constitute a rare group of causes of death, but contribute to mortality through multiple comorbidities. Classification systems could be adapted to better encompass these diseases as a category. Key messages Reclassification of readily available data provides useful estimates for the mortality burden of systemic autoimmune diseases in the population.

Intercapitalist Maneuvers and the ICD-10 Transition: The Instrumental Role of the State in the Corporate Governance of U.S. Health Care

2019 ◽  
Vol 49 (3) ◽  
pp. 457-475 ◽  
Author(s):  
Mary Bugbee
Keyword(s):  
Health Care ◽  
Corporate Governance ◽  
Financial Burden ◽  
Health Sector ◽  
The United States ◽  
The State ◽  
Coding System ◽  
Role Of The State ◽  
Icd 10

In 2015, the United States transitioned to the ICD-10-CM/PCS, a comprehensive updated coding system for medical reimbursement. This transition was part of a larger move toward value-based reimbursement in U.S. health care and required nearly 2 decades of planning. As an unfunded mandate from Congress, it created a substantial financial burden for many groups within the health sector. This article traces the ICD-10 transition using the concept of the corporate governance of health care, attending to the role the state plays in mediating intercapitalist maneuvers. The ICD-10 was not a simple top-down declaration originating in a neutral state. Rather, it was produced and modified through lobbying efforts on the part of various stakeholders who, along with their competitors, would be affected by the transition in differential ways. The health information technology industry, in particular, stood to gain the most from this transition, at the expense of other capitalist players. An examination of the intercapitalist maneuevers behind the ICD-10 transition demonstrates that even when corporate powers govern U.S. health care, the role of the state should not be written off as inconsequential but rather interrogated and analyzed in relation to the corporate interests with which it is entangled.

scholarly journals Ketidaktepatan Kode Sebab Dasar Kematian menjadi Penyebab Kerugian 600 Juta Dana di Unit ICCU RSUD dr Moh Saleh Probolinggo

2020 ◽  
Vol 3 (1) ◽  
pp. 19
Author(s):  
Novita Sari ◽  
Dewi Rokhmah ◽  
Isa Ma’rufi
Keyword(s):  
Cause Of Death ◽  
World Health ◽  
Care Hospital ◽  
Diagnosis Codes ◽  
Case System ◽  
Icd 10 ◽  
Coding Manual ◽  
Underlying Cause Of Death ◽  
Health Organization ◽  
Coding Rules

The coding of the diagnosis is important for patient care, hospital management and research. However, coding accuracy is a major problem in the diagnosis process and has impact on hospital income levels. This study is about the inaccuracy of the underlying cause of death coding toward the level of hospital income. The Methods employed is the Analysis of the accuracy of the diagnosis according to the mortality coding rules compiled in the Instruction Coding Manual of the World Health Organization (WHO). Afterwards, the percentage of losses is calculated using the system of INAcbg’s, in the Diagnosis Based on Indonesian Case system. The result shows that, out of 176 files were studied, 114 files or 65% of the diagnosis codes of the cause of death were incorrect, 57 files or 32% were correct and 5 files or 3% of files were not coded. Further, the study found out that 65% of these inaccuracies contributed to hospital losses which includes 40-75 % loss with the total loss received by the hospital as much as IDR 597,849,006 or nearly 600 million rupiah. The research concludes that the absence of a diagnosis of death increases hospital losses by more than 40% to 75%. Keywords: Accuracy, Code of Basic Cause of Death, ICD 10

scholarly journals Comparing identification of children and young people with a life limiting condition from cause of death with use of an ICD-10 coding framework applied to routine clinical data

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Stuart Jarvis ◽  
Lorna Fraser
Keyword(s):  
Young People ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Age Groups ◽  
Survival Times ◽  
Children And Young People ◽  
Icd 10 ◽  
Underlying Cause Of Death ◽  
Birth Records ◽  
The Individual

ABSTRACTObjectivesTo compare methods of estimating prevalence of life limiting conditions (LLC) among children and young people (CYP) using (i) cause of death recorded on death certificates and (ii) diagnostic codes in routinely collected inpatient and birth records. ApproachCYP with a LLC were identified from NHS inpatient and birth records in Scotland from 1 April 2003 to 30 March 2014 using a LLC ICD-10 coding framework. The cohort was restricted to individuals who died in the study period. For each cohort member, the LLC coding framework was used to determine whether a diagnosis identified as a LLC was recorded as the underlying cause of death. For those without LLC as an underlying cause of death, the underlying cause was checked to determine whether it was related to LLC – either itself indicative of LLC when recorded on a death certificate or related to one or more of the LLCs identified in the individual’s inpatient and birth records. Finally, for those with underlying cause of death neither a LLC nor related to a LLC, the contributing causes of death were checked against the coding framework for LLC; where found, the individual was marked as having a LLC as a contributing cause of death. These analyses were undertaken for the whole cohort, per year, by age groups and by diagnostic categories. Results20436 CYP with a LLC were identified between 1 April 2009 and 31 March 2014, of which 2249 had died and had a death register record. Of these, 1291 (57%) had a LLC as underlying cause of death; 319 (14%) had an LLC-related underlying cause of death and 268 (12%) had LLC only among contributing causes of death. 371 (16%) had no indication of LLC in their death records. Recording of a LLC as underlying cause of death was lower (41%) amongst under 1 year olds and also varied widely by diagnostic group. ConclusionAround one in six of CYP identified using the coding framework as having a LLC (and almost one in five of under 1s) would not have been so identified using all causes of death in death records. More than a quarter (28%) would be missed if only underlying cause of death was used. This, combined with longer survival times, means use of death records has the potential to greatly underestimate prevalence of LLC in children and young people.

Decline in overall pulmonary embolism-related mortality and increasing prevalence of cancer-associated events in the Veneto region (Italy), 2008-2019

2021 ◽  
Author(s):  
Luca Valerio ◽  
Ugo Fedeli ◽  
Elena Schievano ◽  
Francesco Avossa ◽  
Stefano Barco
Keyword(s):  
Cause Of Death ◽  
Death Certificate ◽  
Northern Italy ◽  
Veneto Region ◽  
Diagnostic Practices ◽  
Epidemiological Changes ◽  
Underlying Cause Of Death ◽  
Standardized Mortality Rate ◽  
Prevalence Of Cancer ◽  
Related Mortality

Background. Despite evidence of ongoing epidemiological changes in deaths from venous thromboembolism in high-income countries, little recent information is available on the time trends in mortality related to PE as underlying or concomitant cause of death in Europe. Methods. We accessed the regional database of death certificates of Veneto Region (Northern Italy, population 4,900,000) from 2008 to 2019. We analysed the trends in crude and age-adjusted annual rates of mortality related to PE (reported either as underlying cause or in any position in the death certificate) using Joinpoint regression; in the contribution of PE to mortality (proportionate mortality); and, using logistic regression, in the association between PE and cancer at death. Results. Between 2008 and 2019, the age-standardized mortality rate related to PE in Veneto decreased from 20.7 to 12.6 annual deaths per 100,000 population for PE in any position of the death certificate, and from 4.6 to 2.2 annual deaths per 100,000 population for PE as underlying cause of death. PE-related proportionate mortality remained up to twice as high in women. The age- and sex-adjusted odds ratio for cancer in deaths with (vs. without) PE constantly increased from 1.01 (95% CI 0.88-1.16) in 2008 to 1.58 (95% CI 1.35-1.83) in 2019. Conclusions. The descending trend in PE-related mortality reported for Europe up to 2015 for both sexes continued thereafter in Northern Italy. However, sex differences in proportionate mortality persist, and the increasing association between PE and cancer at death may reflect changes in risk factor distribution or diagnostic practices.

Abstract P096: Trends in Heart Disease Mortality Among Mississippi Adults Over a Three Decade Period, 1980 Through 2013

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Vincent L. Mendy ◽  
Rodolfo Vargas ◽  
Lamees El-sadek ◽  
Abigail Gamble
Keyword(s):  
Heart Disease ◽  
Cause Of Death ◽  
International Classification Of Diseases ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Annual Percent Change ◽  
Percent Change ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Underlying Cause Of Death

Background: Heart disease (HD) mortality has declined in Mississippi over recent decades however it remains as the leading cause of death among Mississippians. Trends in Mississippi HD mortality have not been thoroughly explored. This study examined trends in HD mortality from 1980 through 2013 among Mississippi adults (≥ 25 years) and further assessed trends by race and sex. Methods and Results: Data from Mississippi Vital Statistics (1980 through 2013) were used to calculate age-specific HD mortality rates for Mississippi adults. Cases were identified using underlying cause of death codes from the International Classification of Diseases, Tenth Revision (ICD-10), including I00-I09, I11, I13, and I20-I51. Joinpoint software was used to calculate the average annual percent change in HD mortality rates for the overall population and by race, sex, and race and sex. Overall, the age-adjusted HD mortality rates among Mississippi adults decreased by 36.5% between 1980 and 2013 with an average annual percent change of -1.60% (95% CI -2.0 to -1.3). During this period, HD mortality rates decreased annually on average by -1.30% (95% CI -1.98 to -0.69) for black adults; by -1.60% (95% CI -1.74 to -1.46) for white adults; by -1.30% (95% CI -1.5 to -1.1) for all females, and by -1.90% (95% -2.2 to -1.5) for all males. Conclusions: Between 1980 and 2013 a continual decrease in HD mortality among Mississippi adults was observed. Disparities in the magnitude of the decrease in HD mortality existed by race and sex.

scholarly journals Systemic autoimmune disease as a cause of death: mortality burden and comorbidities

Rheumatology ◽  
2020 ◽  
Author(s):  
Marianna Mitratza ◽  
Bart Klijs ◽  
A Elisabeth Hak ◽  
Jan W P F Kardaun ◽  
Anton E Kunst
Keyword(s):  
Mortality Rate ◽  
Autoimmune Diseases ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Death Certificate ◽  
Subcutaneous Tissue ◽  
Classification Systems ◽  
Systemic Autoimmune Disease ◽  
Systemic Autoimmune Diseases ◽  
Icd 10

Abstract Objectives Systemic autoimmune diseases (SAIDs) have chronic trajectories and share characteristics of self-directed inflammation, as well as aspects of clinical expression. Nonetheless, burden-of-disease studies rarely investigate them as a distinct category. This study aims to assess the mortality rate of SAIDs as a group and to evaluate co-occurring causes of death. Methods We used death certificate data in the Netherlands, 2013–2017 (N = 711 247), and constructed a SAIDs list at the fourth-position ICD-10 level. The mortality rate of SAIDs as underlying cause of death (CoD), non-underlying CoD, and any-mention CoD was calculated. We estimated age-sex-standardized observed/expected (O/E) ratios to assess comorbidities in deaths with SAID relative to the general deceased population. Results We observed 3335 deaths with SAID on their death certificate (0.47% of all deaths). The mortality rate of SAID was 14.6 per million population as underlying CoD, 28.0 as non-underlying CoD, and 39.7 as any-mention CoD. The mortality rate was higher for females and increased exponentially with age. SAID-related deaths were positively associated with all comorbidities except for solid neoplasms and mental conditions. Particularly strong was the association with diseases of the musculoskeletal system (O/E = 3.38; 95% CI: 2.98, 3.82), other diseases of the genitourinary system (O/E = 2.73; 95% CI: 2.18, 3.38), influenza (O/E = 2.71; 95% CI: 1.74, 4.03), blood diseases (O/E = 2.02; 95% CI: 1.70, 2.39), skin and subcutaneous tissue diseases (O/E = 1.95; 95% CI: 1.54, 2.45), and infectious diseases (O/E = 1.85; 95% CI: 1.70, 2.01). Conclusion Systemic autoimmune diseases constitute a rare group of causes of death, but contribute to mortality through multiple comorbidities. Classification systems could be adapted to better encompass these diseases as a category.

scholarly journals Time series of diabetes attributable mortality from 2008 to 2017

2021 ◽  
Author(s):  
U. Fedeli ◽  
E. Schievano ◽  
S. Masotto ◽  
E. Bonora ◽  
G. Zoppini
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Death Certificate ◽  
Attributable Mortality ◽  
Joinpoint Regression ◽  
Annual Percent Change ◽  
Percent Change ◽  
Underlying Causes ◽  
Underlying Cause Of Death ◽  
Circulatory Diseases

Abstract Purpose Diabetes is a growing health problem. The aim of this study was to capture time trends in mortality associated with diabetes. Methods The mortality database of the Veneto region (Italy) includes both the underlying causes of death, and all the diseases mentioned in the death certificate. The annual percent change (APC) in age-standardized rates from 2008 to 2017 was computed by the Joinpoint Regression Program. Results Overall 453,972 deaths (56,074 with mention of diabetes) were observed among subjects aged ≥ 40 years. Mortality rates declined for diabetes as the underlying cause of death and from diabetes-related circulatory diseases. The latter declined especially in females − 4.4 (CI 95% − 5.3/− 3.4), while in males the APC was − 2.8 (CI 95% − 4.0/− 1.6). Conclusion We observed a significant reduction in mortality during the period 2008–2017 in diabetes either as underlying cause of death or when all mentions of diabetes in the death certificate were considered.

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