Social and contextual factors in the analysis of mortality in end-stage renal disease patients: implications for health policy.

A sample of medical records of decreased End-Stage Renal Disease (ESRD) patients was reviewed by a panel of experienced clinicians. The panel's determination of cause of death was compared to that reported for these patients in the Health Care Financing Administration Management Information System. There was concurrence in only 25 per cent of the cases. The difference is attributable to increased awareness of psychosocial and behavioral antecedent factors surrounding the occurrence of death.