Misuse Assigned codes to underlying Causes of Death in Certificates: Instructional Compared to Non- Instractional Kermanshah Hospitals

Information, derived from death certificates specifically cause of death and mortality rates are a part of basic national databases. Because health statistics, national mortality and morbidity statistics, and data on diseases prevalence would come from death certificates, to ensure a complete and accurate record death certificate is very important. The purpose of this study was to determine inappropriate cause of death record in certificates and its comparison between instructional and non-instructional hospitals in Kermanshah city. This was a descriptive analytical study. The study population consisted of patients who died in the first half of 2007 in instructional and non-instructional hospitals in Kermanshah. Random sampling and data collection were done through a checklist and descriptive statistical methods were used to analyze the data. In this study the total sample of 321 hospital deaths in Kermanshah, were surveyed. Samples include 92 death certificates in instructional hospitals and 229 in non-instructional hospitals. Relationship between type of hospital and assingned garbage codes (p=0.003) and global groups of diseases (p=0.009) as the cause of death on issued certificates were valid (more misuses occur in non-structional hospitals). Using garbage, impossible, improbable codes and the one referred to a global group of diseases for assigning underlying cause of death was significantly increased in instructional and non-instructional hospitals. According to the results, postgraduate education of physicians and more practices to identify the cause of death, specifically in non-instructional hospitals, is essential to improve the quality of a death data gathering.