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.
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
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%.
There is considerable scope for improvement in the quality of death certification in hospitals through appropriate and timely training of certifying physicians.
Key-words:cause of death, death certificate, quality control, India
- Completeness of death certificates by physicians was high (>95%)
- Accuracy of death certification was suboptimal with 80% of death certificates having at least one major error and proportion of error-free certificates being <5%
- Appropriate training of certifying physicians is critical to improving quality of death certification
Friday, April 22, 2016