Abstract
Deaths certified with ill-defined causes or garbage codes (GC) compromise the analysis of mortality and its use for planning and evaluation of public health policies. The hospital investigation of these causes is one of the strategies qualifying the profile of mortality in the country. To evaluate the change in the hospital mortality profile after investigation of deaths certified with GC in 2017 in Belo Horizonte, Brazil. A sample of hospital deaths reported with GC in the Mortality Information System (SIM) of Belo Horizonte in 2017 was investigated and subsequently certified by a physician to compare the mortality profile before and after investigation. After investigating 1,395 deaths out of 3,038 reported with GC, a reduction of 35.5% of these causes was observed. Groups of all ages presented decreases in GC occurrence. A higher proportional increase was observed for deaths due to ischemic heart diseases, Alzheimer's disease, chronic obstructive pulmonary disease, ischemic and hemorrhagic stroke, and external causes of death (accidental falls, homicides and traffic/transport accidents). The investigation on reported hospital deaths is one of the strategies to improve mortality statistics, reducing the occurrence of GC among reported deaths and changing the mortality profile in these facilities. The importance of continuous physician training in cause-of-death certification is emphasized.
Highlights
Deaths certified with ill-defined causes or garbage codes (GC) compromise the analysis of mortality and its use for planning and evaluation of public health policies
A sample of hospital deaths reported with GC in the Mortality Information System (SIM) of Belo Horizonte in 2017 was investigated and subsequently certified by a physician to compare the mortality profile before and after investigation
A higher proportional increase was observed for deaths due to ischemic heart diseases, Alzheimer’s disease, chronic obstructive pulmonary disease, ischemic and hemorrhagic stroke, and external causes of death
Summary
Deaths certified with ill-defined causes or garbage codes (GC) compromise the analysis of mortality and its use for planning and evaluation of public health policies. We emphasize that the proportion of deaths whose underlying cause is declared by the physician as nonspecific, including the codes from chapter XVIII of the International Statistical Classification of Diseases and Health-related Problems – 10a Review (ICD-10), and codes of other chapters, among the problems involving the quality of information on mortality. These causes have been denominated incomplete, unhelpful causes or garbage codes (GC), as proposed by the Global Burden of Disease initiative (GBD); and compromise the analysis of mortality when occur in high proportion[4,5]. In Brazil, 33% of about 1.3 million total deaths in 2016 were declared with GC, with a similar proportion among hospital deaths[7]
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