Completeness and accuracy of cause-of-death certification in a tertiary-care teaching hospital in Bangalore city, southern India: scope for improvement

Authors : Varadharajan KS, Mony PK

Publication Year : 2014

Abstract :

CONTEXT:

Accurate and reliable information on cause-of-death (CoD) information is vital for improving the quality of care and for policy-making.The Medical Certification of Cause-of-Death (MCCD) is the national health information system for reporting and studying deaths certified by physicians in India.

AIMS:

The aim of our study was to assess the completeness and accuracy of reporting of the medical certification of cause-of-death (MCCD) system in a tertiary-care hospital in southern India

Settings and Design: We employed a cross-sectional epidemiological study design in a tertiary-care teaching hospital in Bangalore city, southern India.

METHODS AND MATERIAL:

Data was abstracted on an online database on  a server using a combination of a mobilephone-based questionnaire by a research assistant followed by online review by two physicians. Two hundred and forty five death certificates completed during a 4-month period in 2011 were reviewed.

Statistical analysis used: Simple descriptive statistics

RESULTS:

An appropriate death certificate was used in all cases; and completeness of relevant information on the deceased, hospital details, the certifying physician and on manner of death was seen in 98%. Accuracy of certification was however suboptimal. A major error was noted in about 80% of certificates; and a minor error in nearly 95% of certificates. The commonest major error (71%) was incorrect sequencing of events leading to death. Overall proportion of error-free death certificates was only 5%.

CONCLUSIONS:

There is considerable scope for improvement in the quality of death certification in hospitals through appropriate and timely training of certifying physicians.