ArticlePopulation health metrics2018
Assessing the quality of medical death certification: a case study of concordance between national statistics and results from a medical record review in a regional hospital in the Philippines.
Article in Population health metrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Accuracy of Death Certificates for Children: A Population-Based Retrospective Analysis.Pediatric reports · 2025Article
- Comprehensive Evaluation of a 1021-Gene Panel in FFPE and Liquid Biopsy for Analytical and Clinical Use.International journal of molecular sciences · 2025Article
- Accuracy of information on the underlying cause of death: An analysis in Colombia during the COVID-19 pandemic in 2021.PloS one · 2025Article
- Challenges facing physicians in death certification of under-five mortality in Egypt.BMC health services research · 2024Article
- Predictive factors for recording the death of women of childbearing age in the Hospital Information System (SIH/SUS), Brazil, 2012-2020.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2024Article
- Assessing the policy utility of routine mortality statistics: a global classification of countries.Bulletin of the World Health Organization · 2023Article
- A PRECEDE-PROCEED Approach in the Advocacy for Computer-based Education on Correct Medical Certification of Cause of Death among Physician-Learners.Acta medica Philippina · 2023Article
- Factors Associated with Major Errors on Death Certificates.Healthcare (Basel, Switzerland) · 2022Article
- Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records.BMJ open · 2022Article
- Projecting Temperature-Attributable Mortality and Hospital Admissions due to Enteric Infections in the Philippines.Environmental health perspectives · 2022Article
- Association between Ambient Temperature and Severe Diarrhoea in the National Capital Region, Philippines.International journal of environmental research and public health · 2021Article
- Improving cause of death certification in the Philippines: implementation of an electronic verbal autopsy decision support tool (SmartVA auto-analyse) to aid physician diagnoses of out-of-facility deaths.BMC public health · 2021Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundMedical certificates of cause of death (MCCOD) issued by hospital physicians are a key input to vital registration systems. Deaths certified by hospital physicians have been implicitly considered to be of high quality, but recent evidence suggests otherwise. We conducted a medical record review (MRR) of hospital MCCOD in the Philippines and compared the cause of death concordance with certificates coded by the Philippines Statistics Authority (PSA).
methodsMCCOD for adult deaths in Bohol Regional Hospital (BRH) in 2007-2008 and 2011 were collected and reviewed by a team of study physicians. Corresponding MCCOD coded by the PSA were linked by a hospital identifier. The study physicians wrote a new MCCOD using the patient medical record, noted the quality of the medical record to produce a cause of death, and indicated whether it was necessary to change the underlying cause of death (UCOD). Chance-corrected concordance, cause-specific mortality fraction (CSMF) accuracy, and chance-corrected CSMF were used to examine the concordance between the MRR and PSA.
resultsA total of 1052 adult deaths were linked between the MRR and PSA. Median chance-corrected concordance was 0.73, CSMF accuracy was 0.85, and chance-corrected CSMF accuracy was 0.58. 74.8% of medical records were deemed to be of high enough quality to assign a cause of death, yet study physicians indicated that it was necessary to change the UCOD in 41% of deaths, 82% of which required addition of a new UCOD.
conclusionsMedical records were generally of sufficient quality to assign a cause of death and concordance between the PSA and MRR was reasonably high, suggesting that routine mortality statistics data are reasonably accurate for describing population level causes of death in Bohol. While overall agreement between the PSA and MRR in major cause groups was sufficient for public health purposes, improvements in death certification practices are recommended to help physicians differentiate between treatable (immediate) COD and COD that are important for public health surveillance.
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