Lene Mikkelsen1, Kim Moesgaard Iburg2, Tim Adair1, Thomas Fürst3, Michael Hegnauer3, Elena von der Lippe4, Lauren Moran5, Shuhei Nomura6, Haruka Sakamoto6, Kenji Shibuya7, Annelene Wengler4, Stephanie Willbond8, Patricia Wood8, Alan D Lopez9. 1. Bloomberg Data for Health Initiative, University of Melbourne, Melbourne, Australia. 2. Institute of Public Health, Aarhus University, Århus, Denmark. 3. Swiss Tropical and Public Health Institute, Basel, Switzerland. 4. Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany. 5. Australian Bureau of Statistics, Canberra, Australia. 6. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 7. University Institute of Population Health, King's College London, London, UK. 8. Statistics Canada, Ottawa, Canada. 9. Bloomberg Data for Health Initiative, University of Melbourne, Melbourne, Australia. alan.lopez@unimelb.edu.au.
Abstract
OBJECTIVES: To assess the policy utility of national cause of death (COD) data of six high-income countries with highly developed health information systems. METHODS: National COD data sets from Australia, Canada, Denmark, Germany, Japan and Switzerland for 2015 or 2016 were assessed by applying the ANACONDA software tool. Levels, patterns and distributions of unusable and insufficiently specified "garbage" codes were analysed. RESULTS: The average proportion of unusable COD was 18% across the six countries, ranging from 14% in Australia and Canada to 25% in Japan. Insufficiently specified codes accounted for a further 8% of deaths, on average, varying from 6% in Switzerland to 11% in Japan. The most commonly used garbage codes were Other ill-defined and unspecified deaths (R99), Heart failure (I50.9) and Senility (R54). CONCLUSIONS: COD certification errors are common, even in countries with very advanced health information systems, greatly reducing the policy value of mortality data. All countries should routinely provide certification training for hospital interns and raise awareness among doctors of their public health responsibility to certify deaths correctly and usefully for public health policy.
OBJECTIVES: To assess the policy utility of national cause of death (COD) data of six high-income countries with highly developed health information systems. METHODS: National COD data sets from Australia, Canada, Denmark, Germany, Japan and Switzerland for 2015 or 2016 were assessed by applying the ANACONDA software tool. Levels, patterns and distributions of unusable and insufficiently specified "garbage" codes were analysed. RESULTS: The average proportion of unusable COD was 18% across the six countries, ranging from 14% in Australia and Canada to 25% in Japan. Insufficiently specified codes accounted for a further 8% of deaths, on average, varying from 6% in Switzerland to 11% in Japan. The most commonly used garbage codes were Other ill-defined and unspecifieddeaths (R99), Heart failure (I50.9) and Senility (R54). CONCLUSIONS: COD certification errors are common, even in countries with very advanced health information systems, greatly reducing the policy value of mortality data. All countries should routinely provide certification training for hospital interns and raise awareness among doctors of their public health responsibility to certify deaths correctly and usefully for public health policy.
Entities:
Keywords:
Assessment of data; Causes of death; Data quality; Garbage codes; Medical certification
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