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A study of ill-defined causes of death in Bahrain. Determinants and health policy issues
Najat M Abulfatih1, Randah R Hamadeh
1Ministry of Health, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
Insights
Many death certificates in Bahrain had ill-defined causes, with most deaths occurring at home. Improving physician training on accurate death certification is crucial for better mortality data quality.
Area of Science:
- Public Health
- Medical Informatics
- Epidemiology
Background:
- Ill-defined causes of death complicate accurate mortality statistics.
- Accurate death certification is essential for public health surveillance and policy development.
Purpose of the Study:
- To determine the actual causes of death for certificates with ill-defined causes in Bahrain.
- To assess the accuracy of death certificate completion.
- To propose strategies for reducing ill-defined causes of death.
Main Methods:
- Retrospective review of death certificates with ill-defined causes (ICD-10 codes R0-R99) in Bahrain during 2006.
- Analysis of demographic data, place of death, recorded causes, and certifying physicians.
Main Results:
- 76.7% of decedents were Bahraini, 70.6% male, and 37% over 70 years old.
- 62.7% died at home, with 92% of underlying causes listed as 'brought dead' or cardiopulmonary failure.
- 60% of retrieved certificates at Salmaniya Medical Complex (SMC) required correction, primarily by accident and emergency, medical, and surgical departments.
Conclusions:
- Death certification practices in Bahrain require reevaluation by all stakeholders.
- Enhancing physician awareness regarding the implications of inaccurate death certification is recommended.
- Improving the quality of mortality data is essential for public health initiatives.
Objective:
To find the actual cause of death in death certificates that had ill-defined causes in 2006, evaluate the correctness of the completion of those certificates, and recommend ways to decrease the proportion of ill-defined causes of death in Bahrain.
Methods:
This was a retrospective review of all death certificates that had ill-defined as a cause of death (International Classification of Diseases-10 codes R0-R99) from January through December 2006 in Bahrain.
Results:
Of the decedents with ill-defined causes of death in 2006, 76.7% were Bahraini, 70.6% males, 37% older than 70 years, and 62.7% died in their homes. The underlying causes of death of 92% were recorded as brought dead and cardiopulmonary failure. Of those whose place of death was recorded as brought dead'', 86% had died in their homes. Sixty percent of the death certificates were signed by Salmaniya Medical Complex (SMC) physicians and the remaining by forensic doctors and over half by senior residents. Of the death certificates retrieved at SMC, 60% were corrected, 47.4% of which were certified by doctors from the accident and emergency department, 31.5% from medical, and 21.1% from surgical departments.
Conclusion:
Death certification in Bahrain should be reevaluated by all stakeholders to improve the quality of mortality data. The revised policy should stress upon increasing the awareness of the physicians on the implications of inaccurate death certification.
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