Assessing the quality of cause of death data in six high-income countries: Australia, Canada, Denmark, Germany, Japan and Switzerland

Lene Mikkelsen (), Kim Moesgaard Iburg (), Tim Adair (), Thomas Fürst (), Michael Hegnauer (), Elena Lippe (), Lauren Moran (), Shuhei Nomura (), Haruka Sakamoto (), Kenji Shibuya (), Annelene Wengler (), Stephanie Willbond (), Patricia Wood () and Alan D. Lopez ()
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Lene Mikkelsen: University of Melbourne
Kim Moesgaard Iburg: Aarhus University
Tim Adair: University of Melbourne
Thomas Fürst: Swiss Tropical and Public Health Institute
Michael Hegnauer: Swiss Tropical and Public Health Institute
Elena Lippe: Robert Koch Institute
Lauren Moran: Australian Bureau of Statistics
Shuhei Nomura: The University of Tokyo
Haruka Sakamoto: The University of Tokyo
Kenji Shibuya: King’s College London
Annelene Wengler: Robert Koch Institute
Stephanie Willbond: Statistics Canada
Patricia Wood: Statistics Canada
Alan D. Lopez: University of Melbourne

International Journal of Public Health, 2020, vol. 65, issue 1, No 4, 17-28

Abstract: Abstract Objectives To assess the policy utility of national cause of death (COD) data of six high-income countries with highly developed health information systems. Methods National COD data sets from Australia, Canada, Denmark, Germany, Japan and Switzerland for 2015 or 2016 were assessed by applying the ANACONDA software tool. Levels, patterns and distributions of unusable and insufficiently specified “garbage” codes were analysed. Results The average proportion of unusable COD was 18% across the six countries, ranging from 14% in Australia and Canada to 25% in Japan. Insufficiently specified codes accounted for a further 8% of deaths, on average, varying from 6% in Switzerland to 11% in Japan. The most commonly used garbage codes were Other ill-defined and unspecified deaths (R99), Heart failure (I50.9) and Senility (R54). Conclusions COD certification errors are common, even in countries with very advanced health information systems, greatly reducing the policy value of mortality data. All countries should routinely provide certification training for hospital interns and raise awareness among doctors of their public health responsibility to certify deaths correctly and usefully for public health policy.

Keywords: Causes of death; Medical certification; Data quality; Garbage codes; Assessment of data (search for similar items in EconPapers)
Date: 2020
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DOI: 10.1007/s00038-019-01325-x

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