Assessment of the impact of the change from manual to automated coding on mortality statistics in Australia.

It remains unclear whether the change from a manual to an automated coding system (ACS) for deaths has significantly affected the consistency of Australian mortality data. The underlying causes of 34,000 deaths registered in 1997 in Australia were dual coded, in ICD-9 manually, and by using an automated computer coding program. The diseases most affected by the change from manual to ACS were senile/presenile dementia, and pneumonia. The most common disease to which a manually assigned underlying cause of senile dementia was coded with ACS was unspecified psychoses (37.2%). Only 12.5% of codes assigned by ACS as senile dementia were coded the same by manual coders. This study indicates some important differences in mortality rates when comparing mortality data that have been coded manually with those coded using an automated computer coding program. These differences may be related to both the different interpretation of ICD coding rules between manual and automated coding, and different co-morbidities or co-existing conditions among demographic groups.