Cause of death coding in Switzerland: evaluation based on a nationwide individual linkage of mortality and hospital in-patient records
Abstract Background Cause of death statistics are an important tool for quality control of the health care system. Their reliability, however, is controversial. Comparing death certificates with their corresponding medical records is implemented only occasionally but may point to quality problems. W...
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doaj-8429a64f13094d8fa79699bc14b019a22020-11-25T02:08:41ZengBMCPopulation Health Metrics1478-79542019-03-0117111510.1186/s12963-019-0182-zCause of death coding in Switzerland: evaluation based on a nationwide individual linkage of mortality and hospital in-patient recordsUeli Zellweger0Christoph Junker1Matthias Bopp2for the Swiss National Cohort Study GroupEpidemiology, Biostatistics and Prevention Institute, University of ZurichSwiss Federal Statistical OfficeEpidemiology, Biostatistics and Prevention Institute, University of ZurichAbstract Background Cause of death statistics are an important tool for quality control of the health care system. Their reliability, however, is controversial. Comparing death certificates with their corresponding medical records is implemented only occasionally but may point to quality problems. We aimed at exploring the agreement between information in the cause of death statistics and hospital discharge diagnoses at death. Methods Selection of disease categories was based on ICD-10 Tabulation List for Morbidity and ICD-10 Mortality Tabulation List 2. Index cases were defined as deaths having occurred among Swiss residents 2010–2012 in a hospital and successfully linked to the Swiss National Cohort. Rare, external and ill-defined causes were excluded from comparison, leaving 53,605 deaths from vital statistics and 47,311 deaths from hospital discharge statistics. For 95% of individuals, respective information from the 2000 census could be retrieved and used for multiple logistic regression. Results For 83% of individuals the underlying cause of death could be traced among hospital diagnoses and for 77% the principal hospital diagnosis among the cause of death information. Mirroring different evaluation of complex situations by individual physicians, rates of agreement varied widely depending on disease/cause of death, but were generally in line with similar studies. Multiple logistic regression revealed however significant variation in reporting that could not entirely be explained by age or cause of death of the deceased suggesting differential exploitation of available diagnosis information. Conclusion Substantial regional variation and lower agreement rates among socially disadvantaged groups like single, less educated, or culturally less integrated persons suggest potential for improving reporting of diagnoses and causes of death by physicians in Switzerland. Studies of this kind should be regularly conducted as a quality monitoring.http://link.springer.com/article/10.1186/s12963-019-0182-zCause of deathDeath certificateHospital discharge diagnosisMedical record linkageQuality monitoringSwitzerland |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ueli Zellweger Christoph Junker Matthias Bopp for the Swiss National Cohort Study Group |
spellingShingle |
Ueli Zellweger Christoph Junker Matthias Bopp for the Swiss National Cohort Study Group Cause of death coding in Switzerland: evaluation based on a nationwide individual linkage of mortality and hospital in-patient records Population Health Metrics Cause of death Death certificate Hospital discharge diagnosis Medical record linkage Quality monitoring Switzerland |
author_facet |
Ueli Zellweger Christoph Junker Matthias Bopp for the Swiss National Cohort Study Group |
author_sort |
Ueli Zellweger |
title |
Cause of death coding in Switzerland: evaluation based on a nationwide individual linkage of mortality and hospital in-patient records |
title_short |
Cause of death coding in Switzerland: evaluation based on a nationwide individual linkage of mortality and hospital in-patient records |
title_full |
Cause of death coding in Switzerland: evaluation based on a nationwide individual linkage of mortality and hospital in-patient records |
title_fullStr |
Cause of death coding in Switzerland: evaluation based on a nationwide individual linkage of mortality and hospital in-patient records |
title_full_unstemmed |
Cause of death coding in Switzerland: evaluation based on a nationwide individual linkage of mortality and hospital in-patient records |
title_sort |
cause of death coding in switzerland: evaluation based on a nationwide individual linkage of mortality and hospital in-patient records |
publisher |
BMC |
series |
Population Health Metrics |
issn |
1478-7954 |
publishDate |
2019-03-01 |
description |
Abstract Background Cause of death statistics are an important tool for quality control of the health care system. Their reliability, however, is controversial. Comparing death certificates with their corresponding medical records is implemented only occasionally but may point to quality problems. We aimed at exploring the agreement between information in the cause of death statistics and hospital discharge diagnoses at death. Methods Selection of disease categories was based on ICD-10 Tabulation List for Morbidity and ICD-10 Mortality Tabulation List 2. Index cases were defined as deaths having occurred among Swiss residents 2010–2012 in a hospital and successfully linked to the Swiss National Cohort. Rare, external and ill-defined causes were excluded from comparison, leaving 53,605 deaths from vital statistics and 47,311 deaths from hospital discharge statistics. For 95% of individuals, respective information from the 2000 census could be retrieved and used for multiple logistic regression. Results For 83% of individuals the underlying cause of death could be traced among hospital diagnoses and for 77% the principal hospital diagnosis among the cause of death information. Mirroring different evaluation of complex situations by individual physicians, rates of agreement varied widely depending on disease/cause of death, but were generally in line with similar studies. Multiple logistic regression revealed however significant variation in reporting that could not entirely be explained by age or cause of death of the deceased suggesting differential exploitation of available diagnosis information. Conclusion Substantial regional variation and lower agreement rates among socially disadvantaged groups like single, less educated, or culturally less integrated persons suggest potential for improving reporting of diagnoses and causes of death by physicians in Switzerland. Studies of this kind should be regularly conducted as a quality monitoring. |
topic |
Cause of death Death certificate Hospital discharge diagnosis Medical record linkage Quality monitoring Switzerland |
url |
http://link.springer.com/article/10.1186/s12963-019-0182-z |
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