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Factors Associated with Major Errors on Death Certificates
Sangyup Chung1, Sun-Hyu Kim1, Byeong-Ju Park1
1Department of Emergency Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan 44044, Korea.
Abstract:
The objective of this study was to investigate errors on death certificates and factors associated with the occurrence of major errors. A retrospective analysis was conducted for six months in 2020 at a university training hospital. Errors were judged as major and minor errors according to the contribution to the process of determining the cause of death. Death certificates were classified into two groups with major errors (ME group) and without major errors (non-ME group). General characteristics of the death certificates, the main cause of death (cancer, cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, genitourinary disease, intentional self-harm, external causes, and other causes), the number of causes of deaths written on the death certificate, and major and minor errors were investigated. The ME group had 127 cases out of 548 death certificates. The number of causes of deaths written on the death certificates and the total number of errors were higher in the ME group than in the non-ME group. Cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, external causes, and other diseases as causes of deaths had higher risks of major errors on death certificates than cancer as a cause of death. The group with cancer as a cause of death had the lowest incidence of major errors and fewer causes of deaths. To reduce major errors, continuous education and feedback are needed for those who are qualified to issue a death certificate.
Insights
Major errors on death certificates are linked to multiple listed causes of death, particularly cardiovascular and cerebrovascular diseases. Cancer diagnoses showed fewer errors, highlighting areas for improved death certificate accuracy.
Area of Science:
- Medical Informatics
- Public Health
- Epidemiology
Background:
- Accurate death certificates are crucial for mortality statistics and public health.
- Errors in death certificates can misrepresent causes of death, impacting epidemiological data.
- Identifying factors contributing to major errors is essential for improving data quality.
Purpose of the Study:
- To investigate the types and frequency of errors on death certificates.
- To identify factors associated with major errors in death certificate completion.
- To provide insights for reducing inaccuracies in cause-of-death reporting.
Main Methods:
- Retrospective analysis of 548 death certificates from a university training hospital over six months in 2020.
- Classification of errors as major or minor based on their impact on determining the cause of death.
- Comparison of death certificates with major errors (ME group) versus those without (non-ME group).
Main Results:
- 127 out of 548 death certificates (23.2%) had major errors.
- The ME group exhibited a higher number of listed causes of death and total errors compared to the non-ME group.
- Causes of death such as cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, external causes, and others had a higher risk of major errors than cancer.
Conclusions:
- Cancer as a cause of death was associated with the lowest incidence of major errors and fewer listed causes.
- Increased number of causes of death on a certificate correlates with a higher likelihood of major errors.
- Continuous education and feedback for healthcare professionals issuing death certificates are recommended to minimize major errors.
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