The quality of death certificate at the University of the West Indies

ABSTRACT

A study was undertaken to look at the death certification practices of doctors at the University Hospital of the West Indies. Records of the deaths occurring between 1st August, 1992 and 31st July, 1993 were examined. Case notes studied amounted to 502-246 males and 256 females (stillbirths excluded). Ther were 153 adequately completed certificates (30.5 percent); 157 (31.3 percent) had insufficient information and 41 (8.2 percent) had ill-defined or vague cause of death statements. Seventy (13.9 per cent) had blank death certificates or the certificates could not be found. Seventy-eight (15.5 percent) were considered to be inaccurate or misleading. Three (0.6 percent) were found to be illegible. From records found, the post mortem rate was calculated to be 40.4 percent and post mortem findings contributed significantly to the quality of death certification. The confirmation rate of admission diagnoses compared with post mortem findings for all disease categories together was 57 percent. The point is made that the medical students and doctors need to familiarise themselves with the World Health Organization ICD Manual 9th Revision (1975) and other revisions that may come on stream in the future. Education on the importance of death ceritification and the proper certification process to be followed needs to be included in the curriculum of medical students. Doctors and medical records personnel also need ongoing education on this subject, so that all concerned will work together to provide more meaningful information on which sound health planning can be based (AU)