Abstract
BackgroundThe cause of death statistics in Germany include a relatively high share (26% in 2017) of ill-defined deaths (IDD). To make use of the cause of death statistics for Burden of Disease calculations we redistribute those IDD to valid causes of death.MethodsThe process of proportional redistribution is described in detail. It makes use of the distribution of the valid ICD-codes in the cause of death data. We use examples of stroke, diabetes, and heart failure to illustrate how IDD are reallocated.ResultsThe largest increases in the number of deaths for both women and men were found for lower respiratory infections, diabetes mellitus, and stroke. The numbers of deaths for these causes more than doubled after redistribution.ConclusionThis is the first comprehensive redistribution of IDD using the German cause of death statistics. Performing a redistribution is necessary for burden of disease analyses, otherwise there would be an underreporting of certain causes of death or large numbers of deaths coded to residual or unspecific codes.
Highlights
The cause of death statistics in Germany include a relatively high share (26% in 2017) of ill-defined deaths (IDD)
In Germany the cause of death (CoD) are classified according to the principles of the International Statistical Classification of Diseases and Related Health Problems (ICD-10, WHO Version)
In the first part of the results section, we want to illustrate how the redistributed cases are reallocated from IDD to valid causes, looking at specific examples
Summary
The cause of death statistics in Germany include a relatively high share (26% in 2017) of ill-defined deaths (IDD). To make use of the cause of death statistics for Burden of Disease calculations we redistribute those IDD to valid causes of death. Burden of disease (BoD) analyses are performed to assess the health state of populations [1]. The calculation of the YLL is usually based on the cause of death (CoD) statistics, which use information from death certificates. In most cases the death certificate includes more than one cause and often the full chain of events leading to death. In Germany the CoD are classified according to the principles of the International Statistical Classification of Diseases and Related Health Problems (ICD-10, WHO Version). Secondary preceding causes and Wengler et al Archives of Public Health (2021) 79:33 comorbidities recorded on the death certificate are not included in the nationally reported CoD statistics in Germany [5].
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