Certifying diabetes-related cause-of-death: a comparison of inappropriate certification statements in Sweden, Taiwan and the USA.
Open accessAbstract
Aims/hypothesis The aim of this study was to assess differences in the certification practices of physicians in Sweden, Taiwan and the USA with regard to diabetes-related cause-of-death (COD) statements.Methods Multiple-cause-of-death data from Sweden (2000), Taiwan (2001) and the USA (2001) were used for this study. All deaths with mention of diabetes anywhere on the death certificate were extracted for analysis. Two types of inappropriate COD statements were: (1) reporting two or more diagnoses per line; and (2) entering an incorrect causal sequence among reported diagnoses.Results Of those deaths in which diabetes was reported in Part I of the death certificate, American physicians (19%) were less likely to report two or more diagnoses per line than physicians in Sweden (46%) and Taiwan (56%). On the other hand, Swedish physicians (5%) were less likely to report incorrect causal sequences than were their counterparts in Taiwan (21%) and the USA (28%).Conclusions/interpretation These findings reveal substantial differences in diabetes-related COD statements among physicians in Sweden, Taiwan and the USA, implying that caution should be used when interpreting differences in mortality statistics between these countries.
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The validity and comparability of US cause-of-death statistics may be affected at the time of medical certification, especially for cardiovascular causes and diabetes.
“Although the US has automated (computerized) assignment of an International Classification of Diseases (ICD) code for the underlying cause of death, the validity and comparability of cause of death statistics may be affected at the time of medical certification, especially for cardiovascular causes and diabetes [22]–[24].”
From The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors (2009) · cites this paper as [24]
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- Authors
- Lu, T. H., Hsu, P. Y., Bjorkenstam, C., & Anderson, R. N.
- Affiliations
- National Cheng Kung University (TW)
- Department of Health (TW)
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Anderson, R. N.
- Venue
- Diabetologia
- Published
- 2006-10-10
- Volume
- 49
- Issue
- 12
- Pages
- 2878-2881
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W1986267777
- Cited by
- 41
- References
- 9
- Citations by year
- 2024: 1 · 2023: 4 · 2022: 3 · 2019: 4 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 3 · 2013: 1 · 2012: 2
- FWCI
- 5.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Council
- Topics
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Autopsy Techniques and Outcomes
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- cross-national comparison, Sweden, Taiwan, United States
- MeSH terms
- Automation, Cause of Death, Death Certificates, Diabetes Mellitus, Diabetic Angiopathies, Humans, Hypertension, Lung Neoplasms, Physicians, Sweden, Taiwan, United States, Reproducibility of Results, Pulmonary Disease, Chronic Obstructive
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