Cause-specific mortality patterns among hospital deaths in Thailand: validating routine death certification

Population Health Metrics

Research

Junya Pattaraarchachai¹  Wansa Pao-in²  Yawarat Porapakkham³  Noppcha Singwerathum³  Warangkana Polprasert⁴  Chalapati Rao⁵  Alan D Lopez⁶ 

[1] Department of Community Medicine, Thammasat University, Pathumthani, Thailand;Department of Surgery, Thammasat University, Pathumthani, Thailand;Ministry of Public Health, Bangkok, Thailand;School of Health Sciences, Sukhothaithummathirat Open University, Bangkok, Thailand;School of Population Health, University of Queensland, Brisbane, Australia;School of Population Health, University of Queensland, Brisbane, Australia;Health Information Systems Knowledge Hub, University of Queensland, Brisbane, Australia;

关键词: Death Certificate;    Registration Data;    Medical Record Review;    Hospital Death;    Verbal Autopsy;   

DOI  :  10.1186/1478-7954-8-12

 received in 2009-10-14, accepted in 2010-05-18,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundIn Thailand, 35% of all deaths occur in hospitals, and the cause of death is medically certified by attending physicians. About 15% of hospital deaths are registered with nonspecific diagnoses, despite the potential for greater accuracy using information available from medical records. Further, issues arising from transcription of diagnoses from Thai to English at registration create uncertainty about the accuracy of registration data even for specified causes of death. This paper reports findings from a study to measure validity of registered diagnoses in a sample of deaths that occurred in hospitals in Thailand during 2005.MethodsA sample of 4,644 hospital deaths was selected, and for each case, medical records were reviewed. A process of medical record abstraction, expert physician review, and independent adjudication for the selection and coding of underlying causes of death was used to derive reference diagnoses. Validation characteristics were computed for leading causes of hospital deaths from registration data, and misclassification patterns were identified for registration diagnoses. Study findings were used to estimate cause-specific mortality patterns for hospital deaths in Thailand.ResultsAdequate medical records were available for 3,316 deaths in the study sample. Losses to follow up were nondifferential by age, sex, and cause. Medical records review identified specific underlying causes for the majority of deaths that were originally assigned ill-defined causes as well as for those originally assigned to residual categories for specific cause groups. In comparison with registration data for the sample, we found an increase in the relative proportion of deaths in hospitals due to stroke, ischemic heart disease, transport accidents, HIV/AIDS, diabetes, liver diseases, and chronic obstructive pulmonary disease.ConclusionsRegistration data on causes for deaths occurring in hospitals require periodic validation prior to their use for epidemiological research or public health policy. Procedures for death certification and coding of underlying causes of death need to be streamlined to improve reliability of registration data. Estimates of cause-specific mortality from this research will inform burden of disease estimation and guide interventions to reduce avoidable mortality in hospitals in Thailand.

【 授权许可】

Unknown   
© Pattaraarchachai et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.