Improving Quality of Cause-of-Death Reporting in New York City

Abstract

In “Survey of New York City Resident Physicians on Cause-of-Death Reporting, 2010,” (Survey) (1), Wexelman et al reported on New York City (NYC) resident physicians’ self-reported beliefs and behaviors relating to NYC’s cause-of-death reporting system. In mid-2010, they asked residents about their experiences in the prior 1 to 3 years (June 2007–June 2010); they found that only one-third of residents believed cause-of-death reporting was accurate, and about half had knowingly reported at least one inaccurate cause of death, often at the request of a medical examiner or admitting staff or because “the system” would not accept the correct cause. Residents reported most frequently using heart disease as an inaccurate cause of death. These findings reflect previous US-wide (2) and NYC (3) reports of cardiovascular disease death overreporting and poor quality cause-of-death reporting. Survey authors recommended that the system “allow reporting of more causes” and that resident physicians receive better training but did not describe successful quality-improvement efforts undertaken since these residents’ experiences 3 to 6 years ago.