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Investigation of garbage code deaths to improve the quality of cause-of-death in Brazil: results from a pilot study

Raquel Barbosa de Lima1, Ashley Frederes2, Maria Fatima Marinho3

  • 1Coordenação Geral de Informações e Análise Epidemiológica, Departamento de Análise de Saúde e Vigilância de Doenças Não Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde. Brasília (DF) - Brazil.

Revista Brasileira De Epidemiologia = Brazilian Journal of Epidemiology
|December 5, 2019
PubMed

Insights

A pilot study in Brazil successfully investigated garbage codes (GC) in cause of death (CoD) data, improving data reliability. This strategy enhanced CoD certification for over 92% of investigated deaths.

Area of Science:

  • Public Health
  • Mortality Statistics
  • Epidemiology

Background:

  • Reliable cause-of-death (CoD) statistics are crucial for understanding population health trends.
  • Brazil's Mortality Information System faces challenges with 'garbage codes' (GCs) that are not valid underlying causes of death.
  • The Ministry of Health (MoH) aims to reduce the proportion of GCs in mortality data.

Purpose of the Study:

  • To test a comprehensive strategy for investigating garbage code (GC) deaths in Brazil.
  • To improve the accuracy of cause of death (CoD) certification by addressing GCs.

Main Methods:

  • A pilot study was conducted in seven Brazilian cities involving municipal healthcare workers.
  • Information on terminal diseases was collected from hospital records, autopsies, family health teams, and home investigations.
  • Fieldwork was coordinated federally in partnership with state and municipal teams.

Main Results:

  • Physicians analyzed data from 1,242 selected GC deaths.
  • The underlying cause of death was successfully changed to a usable ICD-10 code in 1,055 cases (92.6%).

Conclusions:

  • Health teams demonstrated significant capacity during the pilot implementation.
  • The GC investigation protocol was refined and scaled up to 60 cities in 2017 based on pilot results.
Abstract

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