Using National Inpatient Death Rates as a Benchmark to Identify Hospitals with Inaccurate Cause of Death Reporting -...

Area of Science:

• Public Health
• Epidemiology
• Medical Record Analysis

Background:

• Accurate cause of death reporting is crucial for public health surveillance and hospital quality assessment.
• Previous studies indicate substantial inaccuracies in U.S. cause of death reporting.
• Hospital-specific death rates can highlight potential issues in reporting accuracy.

Purpose of the Study:

• To analyze the accuracy of underlying cause of death reporting in Missouri hospitals with high inpatient death rates.
• To identify specific diseases that are overreported or underreported on death certificates.
• To inform the development of targeted interventions for improving death certificate completion.

Main Methods:

• Utilized Centers for Disease Control and Prevention (CDC) national inpatient death rates as a benchmark.
• Analyzed inpatient death certificates from hospitals in St. Louis and Kansas City metro areas exhibiting high inpatient death rates.
• Compared reported underlying causes of death against CDC's Guidelines for Death Certificate completion.

Main Results:

• 45.8% of analyzed death certificates from selected hospitals showed inconsistencies with CDC guidelines.
• Hospitals with high inpatient death rates were more prone to overreporting heart and renal diseases.
• Cancer was more likely to be underreported as an underlying cause of death in these facilities.

Conclusions:

• Significant discrepancies exist in cause of death reporting among certain Missouri hospitals.
• Overreporting of heart/renal diseases and underreporting of cancer necessitate improved reporting practices.
• A new web-based training module based on CDC guidelines was implemented to enhance reporting accuracy.