EVALUATION OF MEDICAL CERTIFICATION OF CAUSE OF DEATH IN ONE OF THE TEACHING HOSPITALS OF AHMEDABAD.

Death certification is a public health surveillance tool and is very important because morbidity and mortality statistics often come from death-certification data.The present study evaluated the filled in MCCD forms in one of the teaching hospitals of Ahmedabad. Aims: To improve the quality of Medical Certification of Cause of Death. Objectives:  To evaluate the completeness and accuracy of Medical Certification of Cause of Death (MCCD).  To recommend necessary corrective measures to improve completeness and accuracy of MCCD form. Methods and Material: An observational descriptive study of 3212 deaths which occurred in V S General Hospital, Ahmedabad during the period of 1stJanuary 2009 and 31stDecember 2009 was done. MCCD forms filled up by the doctors were studied and observations were made in the pre-designed proforma. Each case paper was reviewed carefully and personal observations were made for evaluation purpose. Data was entered in the Microsoft excel and SPSS software was used for analysis. Z test was used for a test of significance. Results: During the study period of one year 3,212 (7.7%) deaths took place. The completeness of variables such as immediate cause, antecedent cause and underlying cause were 99.8%, 97.7% and 98.4% respectively in MCCD forms. Accuracy of immediate, antecedent and underlying cause of death was 44%, 55% and 69.9%, respectively. Only 1.2% of the MCCD forms were fully accurate as per guidelines of Manual on MCCD, 2009. Conclusions: Overall accuracy in filling up of MCCD forms need to be improved. Regular training of all post graduate students on MCCD to clarify their doubts regarding filling up of forms.