Assessment of death certificates at king Abdul-Aziz university hospital and king Fahad general hospital, Jeddah city, starting from 2009-2011

Rasha Nabeel Awliyaa

JPFCM, Jeddah

Background: National Mortality and morbidity statistics and data on disease prevalence are largely based on death certificates, so it is important that the data is accurate and to ensure proper completion of the death certificate.

Objectives: To evaluate the system of documentation of deaths from 2009-2011 in the two selected hospitals (King Abdul-Aziz university hospital and king Fahad general hospital) and to estimate the prevalence of deaths and their associated factors during the study period 2009-2011. Design and settings: Cross sectional descriptive study design carried out at KAUH and KFGH in Jeddah city, Saudi Arabia.

Methods: An Abstract form from (CDC) is used to obtain the required data that were issued in death certificates of the randomly selected cases from 2009-2011.

Results: Shows that the cardiopulmonary arrest was the commonest direct cause of death (71%) reported in the death certificate, renal failure is the commonest first underlying cause of death (9.3%).When comparing the two hospitals the place 5 of residence of the deceased individuals were documented in (59.3%) of the death certificates issued in KAUH, lower in KFGH (19.8%), and statistically significant p<0.05. Similarly, the documentation of the occupation was significantly higher in KAUH (19.8%) if compared to KFGH (1.2%) p<0.05. On the other hand it was realized that the percentage of death certificates where the final cause of death coincide that recorded in the medical file was significantly higher in KFGH (90.1%) comparable to that in KAUH (75.3%). Regarding title of the certifier, it was observed that while (15%) of death certificates were issued by interns in KAUH, none was found in KFGH and (2.5%) of KFGH were signed by consultants, while non in KAUH, this difference was found to be statistically significant p<0.05.

Conclusions: There are very high rates of poorly completed medical certificates of death highlights a significant failure in the medical schools’ curriculum, as well as a lack of continuing medical education programs, the results demonstrated inadequate practice, training and lack of awareness about importance of medical certificate of cause of death.

Recommendation: Appropriate interventions to improve the accuracy level of physicians’ death certificate completion skills by adopting guidelines and measures like A unified death certificate across all hospitals, CME and Courses provided for all 6 graduated students of medicine, adopting the ICD-10 codes in the certification of the causes of death across all hospitals, computerized forms instead of manual writing, Re-evaluation and co-signature of the death, Periodic auditing of death certificates and feedback.

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