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Dandona R, Khan M. Engagement With Death Registration and Cause-of-Death Reporting to Strengthen Suicide Statistics. CRISIS 2024; 45:249-253. [PMID: 39138983 DOI: 10.1027/0227-5910/a000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Affiliation(s)
- Rakhi Dandona
- Public Health Foundation of India, New Delhi, India
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | - Murad Khan
- Department of Psychiatry and Brain and Mind Institute, Aga Khan University, Karachi, Pakistan
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Samorodskaya IV, Kakorina EP, Chernyavskaya TK, Kotov SV. [Diseases of the nervous system as the underlying cause of death]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:135-142. [PMID: 38261296 DOI: 10.17116/jnevro2024124011135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
OBJECTIVE To identify the leading causes of death in the adult population from the class of diseases of the nervous system (DNS, class G) according to medical death certificates (MDC) and to discuss the problems of their assessment. MATERIAL AND METHODS The source of information was the electronic database of the Main Department of the Civil Registry Office of the Moscow Region. All cases of class G deaths were selected (total 10.739), an analysis was carried out according to underlying cause of death (UCD) codes and the immediate cause of death. RESULTS In 2022, mortality from diseases included in the DNS amounted to 130.7 per 100 000 of the population over 18 years old (100.3 among men, 191.0 among women). The average age of men is 74.3±14.1, women - 83.5±9.9 years (p<0.0001) due to the younger age of death of men from «G31.2 Degeneration of the nervous system caused by alcohol» and a higher contribution of this cause to male mortality; 82.5% of deaths were for codes G90-G99 («Other disorders of the nervous system»); 15.5% were neurodegenerative diseases (G10-G32). Sixty-six percent of all UCD in both women and men accounted for «unspecified encephalopathy» (G93.4), in 2nd place (10.5%) was «cerebral cyst» (G93.0). In 45 cases, code G93.6 (cerebral edema) was mistakenly used as UCD. Differences in the structure of causes of death at home, in hospital and elsewhere are statistically significant (p<0.00001). In 58.3%, cerebral edema and herniation were indicated as the immediate cause of death (G93.6 and G93.5). CONCLUSIONS Nosologically unfounded, insufficiently well-defined UCD were established in most cases of death from DNS, In 0.5% of the total number of deaths from DNS, an erroneous presentation as UCD of transient disorders of cerebral circulation or cerebral edema was noted. The results indicate the need for an analysis of the causes of death based on a comparison of medical records and MDC.
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Affiliation(s)
- I V Samorodskaya
- National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia
| | - E P Kakorina
- Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - T K Chernyavskaya
- Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia
| | - S V Kotov
- Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia
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Adair T, Mikkelsen L, Hooper J, Badr A, Lopez AD. Assessing the policy utility of routine mortality statistics: a global classification of countries. Bull World Health Organ 2023; 101:777-785. [PMID: 38046370 PMCID: PMC10680110 DOI: 10.2471/blt.22.289036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 03/29/2023] [Accepted: 08/16/2023] [Indexed: 12/05/2023] Open
Abstract
Objective To evaluate the utility and quality of death registration data across countries. Methods We compiled routine death and cause of death statistics data from 2015-2019 from national authorities. We estimated completeness of death registration using the Adair-Lopez empirical method. The quality of cause of death data was assessed by evaluating the assignment of usable causes of death among people younger than 80 years. We grouped data into nine policy utility categories based on data availability, registration completeness and diagnostic precision. Findings Of an estimated 55 million global deaths in 2019, 70% of deaths were registered across 156 countries, but only 52% had medically certified causes and 42% of deaths were assigned a usable cause. In 54 countries, which are mostly high-income, there is complete and high-quality mortality data. In a further 29 countries, located across different regions, death registration is complete, but cause of death data quality remains suboptimal. Additionally, 37 countries possess functional death registration systems with cause of death data of poor to moderate quality. In 30 countries, death registration ranges from limited to nascent completeness, accompanied by poor or unavailable cause of death data. Furthermore, 38 countries lack accessible data altogether. Conclusion By implementing more proactive death notification processes, expanding the use of digitized data collection platforms, streamlining data compilation procedures and improving data quality assessment, governments could enhance the policy utility of mortality data. Encouraging the routine application of automated verbal autopsy methods is crucial for accurately determining the causes of deaths occurring at home.
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Affiliation(s)
- Tim Adair
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, 32 Lincoln Square North, Carlton3053, Victoria, Australia
| | | | | | - Azza Badr
- Division of Data, Analytics and Delivery for Impact, World Health Organization, Geneva, Switzerland
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Factors Associated with Major Errors on Death Certificates. Healthcare (Basel) 2022; 10:healthcare10040726. [PMID: 35455903 PMCID: PMC9029766 DOI: 10.3390/healthcare10040726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/30/2022] [Accepted: 04/11/2022] [Indexed: 11/26/2022] Open
Abstract
The objective of this study was to investigate errors on death certificates and factors associated with the occurrence of major errors. A retrospective analysis was conducted for six months in 2020 at a university training hospital. Errors were judged as major and minor errors according to the contribution to the process of determining the cause of death. Death certificates were classified into two groups with major errors (ME group) and without major errors (non-ME group). General characteristics of the death certificates, the main cause of death (cancer, cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, genitourinary disease, intentional self-harm, external causes, and other causes), the number of causes of deaths written on the death certificate, and major and minor errors were investigated. The ME group had 127 cases out of 548 death certificates. The number of causes of deaths written on the death certificates and the total number of errors were higher in the ME group than in the non-ME group. Cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, external causes, and other diseases as causes of deaths had higher risks of major errors on death certificates than cancer as a cause of death. The group with cancer as a cause of death had the lowest incidence of major errors and fewer causes of deaths. To reduce major errors, continuous education and feedback are needed for those who are qualified to issue a death certificate.
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Chen L, Xia T, Yuan ZA, Rampatige R, Chen J, Li H, Adair T, Yu HT, Bratschi M, Setel P, Rajasekhar M, Chowdhury HR, Gamage SH, Fang B, Azam O, Santon R, Gu Z, Tan Z, Wang C, Lopez AD, Wu F. Are cause of death data for Shanghai fit for purpose? A retrospective study of medical records. BMJ Open 2022; 12:e046185. [PMID: 35168960 PMCID: PMC8852669 DOI: 10.1136/bmjopen-2020-046185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To assess the quality of cause of death reporting in Shanghai for both hospital and home deaths. DESIGN AND SETTING Medical records review (MRR) to independently establish a reference data set against which to compare original and adjusted diagnoses from a sample of three tertiary hospitals, one secondary level hospital and nine community health centres in Shanghai. PARTICIPANTS 1757 medical records (61% males, 39% females) of deaths that occurred in these sample sites in 2017 were reviewed using established diagnostic standards. INTERVENTIONS None. PRIMARY OUTCOME Original underlying cause of death (UCOD) from medical facilities. SECONDARY OUTCOME Routine UCOD assigned from the Shanghai Civil Registration and Vital Statistics (CRVS) system and MRR UCODs from MRR. RESULTS The original UCODs as assigned by doctors in the study facilities were of relatively low quality, reduced to 31% of deaths assigned to garbage codes, reduced to 2.3% following data quality and follow back procedures routinely applied by the Shanghai CRVS system. The original UCOD had lower chance-corrected concordance and cause-specific mortality fraction accuracy of 0.57 (0.44, 0.70) and 0.66, respectively, compared with 0.75 (0.66, 0.85) and 0.96, respectively, after routine data checking procedures had been applied. CONCLUSIONS Training in correct death certification for clinical doctors, especially tertiary hospital doctors, is essential to improve UCOD quality in Shanghai. A routine quality control system should be established to actively track diagnostic performance and provide feedback to individual doctors or facilities as needed.
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Affiliation(s)
- Lei Chen
- Vitral Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Tian Xia
- Division of Public Health and Program Management, Shanghai Institute of Preventive Medicine, Shanghai, China
| | - Zheng-An Yuan
- Central Office, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Rasika Rampatige
- Melbourne School Of Population And Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jun Chen
- Cancer Registration and Civil Statistic, Shanghai Putuo District Center for Disease Control and Prevention, Shanghai, China
| | - Hang Li
- Melbourne School Of Population And Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Timothy Adair
- Melbourne School Of Population And Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hui-Ting Yu
- Vitral Statistics, Shanghai Institute of Preventive Medicine, Shanghai, China
| | - Martin Bratschi
- Public Health Programs, Vital Strategies, New York, New York, USA
| | - Philip Setel
- Public Health Programs, Vital Strategies, New York, New York, USA
| | - Megha Rajasekhar
- Melbourne School Of Population And Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - H R Chowdhury
- Melbourne School Of Population And Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Saman Hattotuwa Gamage
- Melbourne School Of Population And Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Bo Fang
- Vitral Statistics, Shanghai Institute of Preventive Medicine, Shanghai, China
| | - Omair Azam
- Public Health Programs, Vital Strategies, New York, New York, USA
| | - Romain Santon
- Public Health Programs, Vital Strategies, New York, New York, USA
| | - Zhen Gu
- Public Health Programs, Vital Strategies, New York, New York, USA
| | - Ziwen Tan
- Vitral Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Chunfang Wang
- Vitral Statistics, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Alan D Lopez
- IHME, University of Washington, Seattle, Washington, USA
| | - Fan Wu
- Shanghai Medical College, Fudan University, Shanghai, China
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Chua PL, Ng CFS, Madaniyazi L, Seposo X, Salazar MA, Huber V, Hashizume M. Projecting Temperature-Attributable Mortality and Hospital Admissions due to Enteric Infections in the Philippines. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:27011. [PMID: 35188405 PMCID: PMC8860302 DOI: 10.1289/ehp9324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/29/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Enteric infections cause significant deaths, and global projection studies suggest that mortality from enteric infections will increase in the future with warmer climate. However, a major limitation of these projection studies is the use of risk estimates derived from nonmortality data to project excess enteric infection mortality associated with temperature because of the lack of studies that used actual deaths. OBJECTIVE We quantified the associations of daily temperature with both mortality and hospital admissions due to enteric infections in the Philippines. These associations were applied to projections under various climate and population change scenarios. METHODS We modeled nonlinear temperature associations of mortality and hospital admissions due to enteric infections in 17 administrative regions of the Philippines using a two-stage time-series approach. First, we quantified nonlinear temperature associations of enteric infections by fitting generalized linear models with distributed lag nonlinear models. Second, we combined regional estimates using a meta-regression model. We projected the excess future enteric infections due to nonoptimal temperatures using regional temperature-enteric infection associations under various combinations of climate change scenarios according to representative concentration pathways (RCPs) and population change scenarios according to shared socioeconomic pathways (SSPs) for 2010-2099. RESULTS Regional estimates for mortality and hospital admissions were significantly heterogeneous and had varying shapes in association with temperature. Generally, mortality risks were greater in high temperatures, whereas hospital admission risks were greater in low temperatures. Temperature-attributable excess deaths in 2090-2099 were projected to increase over 2010-2019 by as little as 1.3% [95% empirical confidence intervals (eCI): -3.1%, 6.5%] under a low greenhouse gas emission scenario (RCP 2.6) or as much as 25.5% (95% eCI: -3.5%, 48.2%) under a high greenhouse gas emission scenario (RCP 8.5). A moderate increase was projected for temperature-attributable excess hospital admissions, from 0.02% (95% eCI: -2.0%, 1.9%) under RCP 2.6 to 5.2% (95% eCI: -12.7%, 21.8%) under RCP 8.5 in the same period. High temperature-attributable deaths and hospital admissions due to enteric infections may occur under scenarios with high population growth in 2090-2099. DISCUSSION In the Philippines, futures with hotter temperatures and high population growth may lead to a greater increase in temperature-related excess deaths than hospital admissions due to enteric infections. Our results highlight the need to strengthen existing primary health care interventions for diarrhea and support health adaptation policies to help reduce future enteric infections. https://doi.org/10.1289/EHP9324.
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Affiliation(s)
- Paul L.C. Chua
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Alliance for Improving Health Outcomes, Inc., Quezon City, Philippines
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Lina Madaniyazi
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Xerxes Seposo
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Miguel Antonio Salazar
- Alliance for Improving Health Outcomes, Inc., Quezon City, Philippines
- Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Veronika Huber
- Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
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Chua PLC, Ng CFS, Rivera AS, Salva EP, Salazar MA, Huber V, Hashizume M. Association between Ambient Temperature and Severe Diarrhoea in the National Capital Region, Philippines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8191. [PMID: 34360484 PMCID: PMC8346076 DOI: 10.3390/ijerph18158191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022]
Abstract
Epidemiological studies have quantified the association between ambient temperature and diarrhoea. However, to our knowledge, no study has quantified the temperature association for severe diarrhoea cases. In this study, we quantified the association between mean temperature and two severe diarrhoea outcomes, which were mortality and hospital admissions accompanied with dehydration and/or co-morbidities. Using a 12-year dataset of three urban districts of the National Capital Region, Philippines, we modelled the non-linear association between weekly temperatures and weekly severe diarrhoea cases using a two-stage time series analysis. We computed the relative risks at the 95th (30.4 °C) and 5th percentiles (25.8 °C) of temperatures using minimum risk temperatures (MRTs) as the reference to quantify the association with high- and low-temperatures, respectively. The shapes of the cumulative associations were generally J-shaped with greater associations towards high temperatures. Mortality risks were found to increase by 53.3% [95% confidence interval (CI): 29.4%; 81.7%)] at 95th percentile of weekly mean temperatures compared with the MRT (28.2 °C). Similarly, the risk of hospitalised severe diarrhoea increased by 27.1% (95% CI: 0.7%; 60.4%) at 95th percentile in mean weekly temperatures compared with the MRT (28.6 °C). With the increased risk of severe diarrhoea cases under high ambient temperature, there may be a need to strengthen primary healthcare services and sustain the improvements made in water, sanitation, and hygiene, particularly in poor communities.
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Affiliation(s)
- Paul L. C. Chua
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki 852-8102, Japan; (C.F.S.N.); (M.H.)
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Alliance for Improving Health Outcomes, Inc., Rm. 406, Veria I Bldg., 62 West Avenue, Barangay West Triangle, Quezon City 1104, Philippines;
| | - Chris Fook Sheng Ng
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki 852-8102, Japan; (C.F.S.N.); (M.H.)
| | - Adovich S. Rivera
- Institute for Public Health and Management, Feinberg School of Medicine, Northwestern University, 633 N. St. Clair Street, 20th Floor, Chicago, IL 60611, USA;
| | - Eumelia P. Salva
- San Lazaro Hospital, Quiricada St., Santa Cruz, Manila 1003, Philippines;
| | - Miguel Antonio Salazar
- Alliance for Improving Health Outcomes, Inc., Rm. 406, Veria I Bldg., 62 West Avenue, Barangay West Triangle, Quezon City 1104, Philippines;
- Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Veronika Huber
- Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Ctra Utrera km 1, 41013 Sevilla, Spain;
| | - Masahiro Hashizume
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki 852-8102, Japan; (C.F.S.N.); (M.H.)
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Cheng KJG, Estrada MAG. Cost-effectiveness analysis of the 2019 cigarette excise tax reform in the Philippines. Prev Med 2021; 145:106431. [PMID: 33493524 DOI: 10.1016/j.ypmed.2021.106431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 11/13/2020] [Accepted: 01/17/2021] [Indexed: 11/26/2022]
Abstract
In this past decade alone, the Philippines has made major strides in increasing the price of cigarettes. This study estimated the cost-effectiveness of the most recent cigarette price increase of about 29% brought about by Republic Act (RA) 11346 in 2019. A static or a single cohort model was populated with locally-sourced inputs whenever possible. Public payer and societal perspectives were taken wherein the former only considered direct costs and tax revenue gained earmarked for the health sector while the latter adds indirect costs in the form of productivity losses. A 7% discount rate was applied. Increasing the price of cigarettes by about 29% was found to prevent about 1961 tobacco-related deaths which translate to about 34,571 disability adjusted life years (DALYs) saved. Savings incurred from hospitalizations prevented and additional excise tax revenues for health was about USD 367 Million. But when productivity losses averted due to the lives saved and the higher cost of hospitalizations were accounted for in the societal perspective, the excise tax reform yielded USD 415 Million net gain. It would save the public payer USD 10,612 per DALY averted while society at large stand to save USD 11,955 per DALY averted. Tax increases like RA 11346 yield significant revenue that can be used towards public health programs.
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Affiliation(s)
- Kent Jason Go Cheng
- Social Science Department, Maxwell School of Citizenship and Public Affairs, Syracuse University, 100 College Place, Lyman Hall Rm 309, Syracuse, NY, USA.
| | - Miguel Antonio Garcia Estrada
- School of Economics, University of the Philippines Diliman, Quezon City, Philippines; Congressional Policy and Budget Research Department, House of Representatives, Republic of the Philippines, 3/F Main Building, House of Representatives, Batasan Hills, Quezon City, Metro Manila, Philippines.
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Joshi R, Hazard RH, Mahesh PKB, Mikkelsen L, Avelino F, Sarmiento C, Segarra A, Timbang T, Sinson F, Diango P, Riley I, Chowdhury H, Asuncion IL, Khanom G, Lopez AD. Improving cause of death certification in the Philippines: implementation of an electronic verbal autopsy decision support tool (SmartVA auto-analyse) to aid physician diagnoses of out-of-facility deaths. BMC Public Health 2021; 21:563. [PMID: 33752622 PMCID: PMC7986549 DOI: 10.1186/s12889-021-10542-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 03/03/2021] [Indexed: 11/19/2022] Open
Abstract
Background The majority of deaths in the Philippines occur out-of-facility and require a medical certificate of cause of death by Municipal Health Officers (MHOs) for burial. MHOs lack a standardised certification process for out-of-facility deaths and when no medical records are available, certify a high proportion of ill-defined causes of death. We aimed to develop and introduce SmartVA Auto-Analyse, a verbal autopsy (VA) based electronic decision support tool in order to assist the MHOs in certifying out-of-facility deaths. Method We conducted a stakeholder consultation, process mapping and a pre-test to assess feasibility and acceptability of SmartVA Auto-Analyse. MHOs were first asked to conduct an open-ended interview from the family members of the deceased, and if they were not able to arrive at a diagnosis, continue the interview using the standardised SmartVA questionnaire. Auto-Analyse then presented the MHO with the three most likely causes of death. For the pilot, the intervention was scaled-up to 91 municipalities. We performed a mixed-methods evaluation using the cause of death data and group discussions with the MHOs. Results Of the 5649 deaths registered, Auto-Analyse was used to certify 4586 (81%). For the remaining 19%, doctors believed they could assign a cause of death based on the availability of medical records and the VA open narrative. When used, physicians used the Auto-Analyse diagnosis in 85% of cases to certify the cause of death. Only 13% of the deaths under the intervention had an undetermined cause of death. Group discussions identified two themes: Auto-Analyse standardized the certification of home deaths and assisted the MHOs to improve the quality of death certification. Conclusion Standardized VA combined with physician diagnosis using the SmartVA Auto-Analyse support tool was readily used by MHOs in the Philippines and can improve the quality of death certification of home deaths. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10542-0.
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Affiliation(s)
- Rohina Joshi
- The George Institute for Global Health, University of New South Wales, Sydney, Australia. .,The George Institute for Global Health, New Delhi, India. .,School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
| | - R H Hazard
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | | | - L Mikkelsen
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - F Avelino
- Epidemiology Bureau, Department of Health, Manila, Philippines
| | - Carmina Sarmiento
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - A Segarra
- Epidemiology Bureau, Department of Health, Manila, Philippines
| | - T Timbang
- Epidemiology Bureau, Department of Health, Manila, Philippines
| | - F Sinson
- Epidemiology Bureau, Department of Health, Manila, Philippines
| | - Patrick Diango
- Epidemiology Bureau, Department of Health, Manila, Philippines
| | - I Riley
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - H Chowdhury
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Irma L Asuncion
- Epidemiology Bureau, Department of Health, Manila, Philippines
| | - G Khanom
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Alan D Lopez
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
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