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Journal Article Epublish 9 citations

PubMed: 31800849 DOI: 10.1590/1980-549720190010.supl.3

Improving the usefulness of mortality data: reclassification of ill-defined causes based on medical records and home interviews in Brazil.

Rev Bras Epidemiol 22Suppl 3(Suppl 3):e190010.supl.3

Authors: Elisabeth Barboza França, Lenice Harumi Ishitani, Renato Azeredo Teixeira, Carolina Cândida da Cunha, Maria Fatima Marinho

Affiliations

  • Public Health Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte (MG) - Brazil.
  • Epidemiology and Health Assessment Research Group, Universidade Federal de Minas Gerais, Belo Horizonte (MG) - Brazil.
  • Institute of Advanced Studies, Universidade de São Paulo, São Paulo (SP) - Brazil.

Abstract

INTRODUCTION

Brazil presented a high proportion of ill-defined causes of death (IDCD) in 2000, compromising accurate cause-of-death analysis.

OBJECTIVE

To analyze specific underlying causes for deaths originally assigned as IDCD in the Mortality Information System (SIM - Sistema de Informação sobre Mortalidade), after investigation activities implemented in country between 2006 and 2017.

METHOD

For all IDCD identified in the SIM, municipal health professionals collected information about the final disease obtained from hospital records, autopsies, forms of family health teams, and home investigation. Specific causes among reclassified IDCD after investigation were evaluated according to age groups and four calendar periods.

RESULTS

Proportions of IDCD reassigned to other causes after review increased over time, reaching 30.1% in 2017. From a total of 257,367 IDCD reclassified in 2006-2017, neonatal-related conditions, injury, ischemic heart disease and stroke were the leading causes detected in the age groups 0-9 years, 10-29 years, 30-69 years, 70 years and over, respectively.

DISCUSSION

The similarity and plausibility of cause-specific proportions derived from the reclassification of IDCD by age group over time indicate the accuracy of the investigation data.

CONCLUSION

High proportions of IDCD reassigned to more informative causes after review indicate the success of this approach to correct misclassification in the SIM, an initiative that should be maintained. Training physicians on death certification along with better quality of medical care and access to health services would lead to further improvement.

MeSH

Mortality, Epidemiology, Cause Of Death, Medical Records

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