Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú

Abstract Background Mortality statistics derived from cause of death data are an important source of information for population health monitoring, priority setting and planning. In Perú, almost all death certificates are issued by doctors because it is a legal requirement. However, the quality of ca...

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Main Authors: Janet Miki, Rasika Rampatige, Nicola Richards, Tim Adair, Juan Cortez-Escalante, Javier Vargas-Herrera
Format: Article
Language:English
Published: BMC 2018-12-01
Series:BMC Public Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12889-018-6264-1
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spelling doaj-7fd8aaba2a294deda44889a453ddaf8e2020-11-25T01:23:26ZengBMCBMC Public Health1471-24582018-12-0118111110.1186/s12889-018-6264-1Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in PerúJanet Miki0Rasika Rampatige1Nicola Richards2Tim Adair3Juan Cortez-Escalante4Javier Vargas-Herrera5Civil Registration and Vital Statistics, Vital Strategies, Bloomberg Data for Health InitiativeMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbourneCivil Registration and Vital Statistics, Vital Strategies, Bloomberg Data for Health InitiativeAbstract Background Mortality statistics derived from cause of death data are an important source of information for population health monitoring, priority setting and planning. In Perú, almost all death certificates are issued by doctors because it is a legal requirement. However, the quality of cause of death data is poor. In August 2016, the Ministry of Health of Perú decided to make two specific interventions to improve cause of death data: to introduce an online death certification system and to train doctors in standard death certification practices. Methods The study comprised a random sample of 300 pre-intervention death certificates, 900 death certificates that were part of the online intervention, and 900 death certificates that were part of both the online and training interventions. All the deaths had occurred between January and September 2017. We used the Assessing the quality of death certification tool from the University of Melbourne for the assessment. We examined the frequency of common errors in death certificates, the frequency of any error and the average error score for each category of: age group, sex, doctor’s seniority, doctor’s speciality, level of health facility and broad cause of death. Results The average error score declined by 38% due to the online intervention and by a further 26% due to the training intervention. Improved certification practices remained after controlling for potentially confounding factors. Main improvements were reductions in the absence of a time interval (66% of certificates), incorrect sequence of causes (22%), and ill-defined conditions (13%). Conclusions This study demonstrates how the two interventions introduced by the Ministry of Health in Perú improved the correctness of death certificates. The study also provides evidence on necessary changes to the training program to address the poor certification practices that have remained after implementation of the online system.http://link.springer.com/article/10.1186/s12889-018-6264-1Cause of deathCertificationInterventionMortalityOnlinePerú
collection DOAJ
language English
format Article
sources DOAJ
author Janet Miki
Rasika Rampatige
Nicola Richards
Tim Adair
Juan Cortez-Escalante
Javier Vargas-Herrera
spellingShingle Janet Miki
Rasika Rampatige
Nicola Richards
Tim Adair
Juan Cortez-Escalante
Javier Vargas-Herrera
Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú
BMC Public Health
Cause of death
Certification
Intervention
Mortality
Online
Perú
author_facet Janet Miki
Rasika Rampatige
Nicola Richards
Tim Adair
Juan Cortez-Escalante
Javier Vargas-Herrera
author_sort Janet Miki
title Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú
title_short Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú
title_full Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú
title_fullStr Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú
title_full_unstemmed Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú
title_sort saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in perú
publisher BMC
series BMC Public Health
issn 1471-2458
publishDate 2018-12-01
description Abstract Background Mortality statistics derived from cause of death data are an important source of information for population health monitoring, priority setting and planning. In Perú, almost all death certificates are issued by doctors because it is a legal requirement. However, the quality of cause of death data is poor. In August 2016, the Ministry of Health of Perú decided to make two specific interventions to improve cause of death data: to introduce an online death certification system and to train doctors in standard death certification practices. Methods The study comprised a random sample of 300 pre-intervention death certificates, 900 death certificates that were part of the online intervention, and 900 death certificates that were part of both the online and training interventions. All the deaths had occurred between January and September 2017. We used the Assessing the quality of death certification tool from the University of Melbourne for the assessment. We examined the frequency of common errors in death certificates, the frequency of any error and the average error score for each category of: age group, sex, doctor’s seniority, doctor’s speciality, level of health facility and broad cause of death. Results The average error score declined by 38% due to the online intervention and by a further 26% due to the training intervention. Improved certification practices remained after controlling for potentially confounding factors. Main improvements were reductions in the absence of a time interval (66% of certificates), incorrect sequence of causes (22%), and ill-defined conditions (13%). Conclusions This study demonstrates how the two interventions introduced by the Ministry of Health in Perú improved the correctness of death certificates. The study also provides evidence on necessary changes to the training program to address the poor certification practices that have remained after implementation of the online system.
topic Cause of death
Certification
Intervention
Mortality
Online
Perú
url http://link.springer.com/article/10.1186/s12889-018-6264-1
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