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Cited by 64Medical Coding and Health InformationGlobal Health and EpidemiologyInsurance, Mortality, Demography, Risk Management

Cause-specific mortality patterns among hospital deaths in Thailand: validating routine death certification

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Pattaraarchachai, Junya, Rao, Chalapati, Polprasert, Warangkana, Porapakkham, Yawarat, Pao-in, Wansa, Singwerathum, Noppcha, Lopez, Alan D·2010·Population Health Metrics
DOI 10.1186/1478-7954-8-12PMC PMC2881895
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Abstract

Background: In Thailand, 35% of all deaths occur in hospitals, and the cause of death is medically certified by attending physicians. About 15% of hospital deaths are registered with nonspecific diagnoses, despite the potential for greater accuracy using information available from medical records. Further, issues arising from transcription of diagnoses from Thai to English at registration create uncertainty about the accuracy of registration data even for specified causes of death. This paper reports findings from a study to measure validity of registered diagnoses in a sample of deaths that occurred in hospitals in Thailand during 2005. Methods: A sample of 4,644 hospital deaths was selected, and for each case, medical records were reviewed. A process of medical record abstraction, expert physician review, and independent adjudication for the selection and coding of underlying causes of death was used to derive reference diagnoses. Validation characteristics were computed for leading causes of hospital deaths from registration data, and misclassification patterns were identified for registration diagnoses. Study findings were used to estimate cause-specific mortality patterns for hospital deaths in Thailand. Results: Adequate medical records were available for 3,316 deaths in the study sample. Losses to follow up were nondifferential by age, sex, and cause. Medical records review identified specific underlying causes for the majority of deaths that were originally assigned ill-defined causes as well as for those originally assigned to residual categories for specific cause groups. In comparison with registration data for the sample, we found an increase in the relative proportion of deaths in hospitals due to stroke, ischemic heart disease, transport accidents, HIV/AIDS, diabetes, liver diseases, and chronic obstructive pulmonary disease. Conclusions: Registration data on causes for deaths occurring in hospitals require periodic validation prior to their use for epidemiological research or public health policy. Procedures for death certification and coding of underlying causes of death need to be streamlined to improve reliability of registration data. Estimates of cause-specific mortality from this research will inform burden of disease estimation and guide interventions to reduce avoidable mortality in hospitals in Thailand.

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Authors
Pattaraarchachai, J., Rao, C., Polprasert, W., Porapakkham, Y., Pao-in, W., Singwerathum, N., & Lopez, A. D.
Affiliations
  • Thammasat University (TH)
  • The University of Queensland (AU)
  • Sukhothai Thammathirat Open University (TH)
  • Ministry of Public Health (TH)
Corresponding author
Rao, Chalapati
ORCID
Venue
Population Health Metrics
Publisher
Springer Science and Business Media LLC
Published
2010-05-18
Volume
8
Issue
1
Pages
12-12
ISSN
1478-7954 (ISSN-L)
DOI
10.1186/1478-7954-8-12
PMC
PMC2881895
OpenAlex
W2020414913
Cited by
64
References
18
Citations by year
2025: 1 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 5 · 2019: 6 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 3 · 2014: 11 · 2013: 5 · 2012: 9
FWCI
14.34
Type
journal article
Language
en
Open access
Licence
Locations
  • Population Health Metrics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
  • Greater South Information System
Topics
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
  • Health Sciences › Health Professions › Health Information Management › Global Health and Epidemiology
  • Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
Keywords
in-hospital mortality, cause of death certification, underlying cause of death, medical records review, Thailand, stroke, ischemic heart disease, HIV/AIDS, diabetes mellitus, liver disease, chronic obstructive pulmonary disease, transport accidents, avoidable mortality

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