Cause of death certificates in nursing homes: Does quality matter? A retrospective review from two counties in Norway.

Autor:	Eng HM; Department of Pathology, Akershus University Hospital, Norway., L Ellingsen C; Department of Pathology, Stavanger University Hospital, Norway., Pedersen AG; Norwegian Cause of Death Registry, Department of Health Registries, Norwegian Institute of Public Health, Norway., Alfsen GC; Department of Pathology, Akershus University Hospital, Norway.; Faculty of Medicine, University of Oslo, Norway.
Jazyk:	angličtina
Zdroj:	Scandinavian journal of public health [Scand J Public Health] 2024 Aug; Vol. 52 (6), pp. 711-717. Date of Electronic Publication: 2023 Jul 26.
DOI:	10.1177/14034948231187512
Abstrakt:	Aims: One half of Norwegians die in nursing homes, where death certificates (DCs) are completed by two types of physicians: in-house physicians or physicians on call. The aims of this study were to examine differences in the quality of DCs due to type of physician and to uncover possible implications of errors for the public statistics. Methods: DCs from the year 2013 from nursing homes in the catchment area of Akershus University Hospital were examined with regard to logical deficiencies, garbage code diagnoses and type of certifying physician. In one third of cases, the registered causes of death were compared to information in the medical records. Results: A total of 873 DCs from 24 nursing homes were evaluated. Physicians on call certified 46% of all deaths. Logical deficiencies were found in 34% of all DCs and were more common in DCs from physicians on call. Garbage code diagnoses were used in every third DC, with 'sudden death' or 'cause of death unknown' preferred by physicians on call and 'unspecified pneumonia' preferred by in-house physicians. Comparisons against medical records uncovered missing information in 49% and 35% of DCs from physicians on call and in-house physicians, respectively. A dementia diagnosis was frequently overlooked by both physician types. Garbage code diagnoses were more common in DCs with missing information from medical records. Conclusions: Error rates in DCs in nursing homes in Norway are high. The results raise concerns about the validity of public cause of death statistics. Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu