Cause-of-death reporting: how to measure inaccurate completion

Accuracy of cause-of-death statistics primarily depends on quality of causes reporting on the death certificate. This study aims to define a set of indicators for monitoring cause-of-death reporting at the population level using information available during the routine data processing. Reports generated by the automated coding system (ACS) were used to define and compute indicators relating to specific aspects of proper completion of death certificates. The analysis was performed on 577,989 certificates, accounting for 98% of those issued inItalyin 2009 (excluding infant deaths). The mean number of causes reported was 4.3, while 46% of certificates reported one single complete sequence. Duration was reported only in 49% of cases, 8% of them with chronological inconsistency between items. The underlying cause of death (UC) was correctly identified and reported by the certifier in 69% of cases. Specific patterns of sequence reporting by UC and the age of the decedent were also observed. The proposed indicators significantly contribute to the evaluation of quality of cause-of-death statistics, for the aspects concerning certificate completion. This approach enables analysis of a wide range of quality dimensions from large scale data and is a useful tool for those countries using automated coding systems. Francesco GRIPPO, Researcher, Socio-demographic and Environmental Statistics Directorate, Italian National Institute of Statistics (Istat), via Cesare Balbo, 16, 00184-Roma, Italy. E-mail: frgrippo@istat.it . Enrico GRANDE, Researcher, Socio-demographic and Environmental Statistics Directorate, Italian National Institute of Statistics (Istat), via Cesare Balbo, 16, 00184-Roma, Italy. E-mail: grande@istat.it . Monica PACE, Researcher, Socio-demographic and Environmental Statistics Directorate, Italian National Institute of Statistics (Istat), via Cesare Balbo, 16, 00184-Roma, Italy, currently at Eurostat, Directorate F, Social statistics, Italy. E-mail: monica.pace@ec.europa.eu .