Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016
Abstract Background Registered causes in vital statistics classified as garbage codes (GC) are considered indicators of quality of cause-of-death data. Our aim was to describe temporal changes in this quality in Brazil, and the leading GCs according to levels assembled for the Global Burden of Disea...
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doaj-fa978f84bedb48ebaeaf14b13f9982952020-11-25T03:55:38ZengBMCPopulation Health Metrics1478-79542020-09-0118S111310.1186/s12963-020-00221-4Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016Elisabeth França0Lenice Harumi Ishitani1Renato Teixeira2Bruce B. Duncan3Fatima Marinho4Mohsen Naghavi5Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas GeraisResearch Group in Epidemiology and Health Evaluation, Universidade Federal de Minas GeraisResearch Group in Epidemiology and Health Evaluation, Universidade Federal de Minas GeraisPrograma de Pós-graduação em Epidemiologia, Universidade Federal do Rio Grande do SulResearch Group in Epidemiology and Health Evaluation, Universidade Federal de Minas GeraisInstitute for Health Metrics and EvaluationAbstract Background Registered causes in vital statistics classified as garbage codes (GC) are considered indicators of quality of cause-of-death data. Our aim was to describe temporal changes in this quality in Brazil, and the leading GCs according to levels assembled for the Global Burden of Disease (GBD) study. We also assessed socioeconomic differences in the burden of different levels of GCs at a regional level. Methods We extracted data from the Brazilian Mortality Information System from 1996 to 2016. All three- and four-digit ICD-10 codes considered GC were selected and classified into four categories, according to the GBD study proposal. GC levels 1 and 2 are the most damaging unusable codes, or major GCs. Proportionate distribution of deaths by GC levels according selected variables were performed. Age-standardized mortality rates after correction of underreporting of deaths were calculated to investigate temporal relationships as was the linear association adjusted for completeness between GC rates in states and the Sociodemographic Index (SDI) from the GBD study, for 1996–2005 and 2006–2016. We classified Brazilian states into three classes of development by applying tertiles cutoffs in the SDI state-level estimates. Results Age-standardized mortality rates due to GCs in Brazil decreased from 1996 to 2016, particularly level 1 GCs. The most important GC groups were ill-defined causes (level 1) in 1996, and pneumonia unspecified (level 4) in 2016. At state level, there was a significant inverse association between SDI and the rate of level 1–2 GCs in 1996–2005, but both SDI and completeness had a non-expected significant direct association with levels 3–4. In 2006–2016, states with higher SDIs tended to have lower rates of all types of GCs. Mortality rates due to major GCs decreased in all three SDI classes in 1996–2016, but GC levels 3–4 decreased only in the high SDI category. States classified in the low or medium SDI groups were responsible for the most important decline of major GCs. Conclusion Occurrence of major GCs are associated with socioeconomic determinants over time in Brazil. Their reduction with decreasing disparity in rates between socioeconomic groups indicates progress in reducing inequalities and strengthening cause-of-death statistics in the country.http://link.springer.com/article/10.1186/s12963-020-00221-4Cause of deathData qualityVital statisticsBrazil |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Elisabeth França Lenice Harumi Ishitani Renato Teixeira Bruce B. Duncan Fatima Marinho Mohsen Naghavi |
spellingShingle |
Elisabeth França Lenice Harumi Ishitani Renato Teixeira Bruce B. Duncan Fatima Marinho Mohsen Naghavi Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016 Population Health Metrics Cause of death Data quality Vital statistics Brazil |
author_facet |
Elisabeth França Lenice Harumi Ishitani Renato Teixeira Bruce B. Duncan Fatima Marinho Mohsen Naghavi |
author_sort |
Elisabeth França |
title |
Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016 |
title_short |
Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016 |
title_full |
Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016 |
title_fullStr |
Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016 |
title_full_unstemmed |
Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016 |
title_sort |
changes in the quality of cause-of-death statistics in brazil: garbage codes among registered deaths in 1996–2016 |
publisher |
BMC |
series |
Population Health Metrics |
issn |
1478-7954 |
publishDate |
2020-09-01 |
description |
Abstract Background Registered causes in vital statistics classified as garbage codes (GC) are considered indicators of quality of cause-of-death data. Our aim was to describe temporal changes in this quality in Brazil, and the leading GCs according to levels assembled for the Global Burden of Disease (GBD) study. We also assessed socioeconomic differences in the burden of different levels of GCs at a regional level. Methods We extracted data from the Brazilian Mortality Information System from 1996 to 2016. All three- and four-digit ICD-10 codes considered GC were selected and classified into four categories, according to the GBD study proposal. GC levels 1 and 2 are the most damaging unusable codes, or major GCs. Proportionate distribution of deaths by GC levels according selected variables were performed. Age-standardized mortality rates after correction of underreporting of deaths were calculated to investigate temporal relationships as was the linear association adjusted for completeness between GC rates in states and the Sociodemographic Index (SDI) from the GBD study, for 1996–2005 and 2006–2016. We classified Brazilian states into three classes of development by applying tertiles cutoffs in the SDI state-level estimates. Results Age-standardized mortality rates due to GCs in Brazil decreased from 1996 to 2016, particularly level 1 GCs. The most important GC groups were ill-defined causes (level 1) in 1996, and pneumonia unspecified (level 4) in 2016. At state level, there was a significant inverse association between SDI and the rate of level 1–2 GCs in 1996–2005, but both SDI and completeness had a non-expected significant direct association with levels 3–4. In 2006–2016, states with higher SDIs tended to have lower rates of all types of GCs. Mortality rates due to major GCs decreased in all three SDI classes in 1996–2016, but GC levels 3–4 decreased only in the high SDI category. States classified in the low or medium SDI groups were responsible for the most important decline of major GCs. Conclusion Occurrence of major GCs are associated with socioeconomic determinants over time in Brazil. Their reduction with decreasing disparity in rates between socioeconomic groups indicates progress in reducing inequalities and strengthening cause-of-death statistics in the country. |
topic |
Cause of death Data quality Vital statistics Brazil |
url |
http://link.springer.com/article/10.1186/s12963-020-00221-4 |
work_keys_str_mv |
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