The quality of death certification practice in Greece

Area of Science:

• Public Health
• Epidemiology
• Medical Statistics

Background:

• Accurate death certification is crucial for public health surveillance and resource allocation.
• Errors in cause of death reporting can lead to flawed national health policies.
• This study addresses the need to quantify death certificate errors and identify contributing factors.

Purpose of the Study:

• To determine the frequency of errors in death certificates.
• To identify factors associated with inaccuracies in cause of death reporting.

Main Methods:

• A cross-sectional study analyzed 5,828 natural death certifications in a Greek region (2006-2010).
• Specific criteria were used to evaluate major and minor errors in death certificates.

Main Results:

• A high rate of major errors (64.6%) was observed, with nearly all certificates containing minor errors.
• Common major errors included non-acceptable causes of death (31.2%) and incorrect sequencing (16.8%).
• Factors associated with errors included advanced age (over 80), rural/semi-urban completion areas, and consultant-grade doctors.

Conclusions:

• Significant recording errors in death certification affect cause of death accuracy in Southern Greece.
• Establishing standard death certification practices is essential due to the impact on mortality statistics and health policies.
• Coordinated educational interventions are recommended to improve accuracy.