An Intervention to Improve Cause-of-Death Reporting in New York City Hospitals, 2009–2010
Open Access
- 18 October 2012
- journal article
- research article
- Published by Centers for Disease Control and Prevention (CDC) in Preventing Chronic Disease
- Vol. 9, E157
- https://doi.org/10.5888/pcd9.120071
Abstract
Poor-quality cause-of-death reporting reduces reliability of mortality statistics used to direct public health efforts. Overreporting of heart disease has been documented in New York City (NYC) and nationwide. Our objective was to evaluate the immediate and longer-term effects of a cause-of-death (COD) educational program that NYC’s health department conducted at 8 hospitals on heart disease reporting and on average conditions per certificate, which are indicators of the quality of COD reporting. From June 2009 through January 2010, we intervened at 8 hospitals that overreported heart disease deaths in 2008. We shared hospital-specific data on COD reporting, held conference calls with key hospital staff, and conducted in-service training. For deaths reported from January 2009 through June 2011, we compared the proportion of heart disease deaths and average number of conditions per death certificate before and after the intervention at both intervention and nonintervention hospitals. At intervention hospitals, the proportion of death certificates that reported heart disease as the cause of death decreased from 68.8% preintervention to 32.4% postintervention (P < .001). Individual hospital proportions ranged from 58.9% to 79.5% preintervention and 25.9% to 45.0% postintervention. At intervention hospitals the average number of conditions per death certificate increased from 2.4 conditions preintervention to 3.4 conditions postintervention (P < .001) and remained at 3.4 conditions a year later. At nonintervention hospitals, these measures remained relatively consistent across the intervention and postintervention period. This NYC health department’s hospital-level intervention led to durable changes in COD reporting.Keywords
This publication has 26 references indexed in Scilit:
- Teaching cause-of-death certification: lessons from international experiencePublished by BMJ ,2010
- The Effect of Student Training on Accuracy of Completion of Death CertificatesMedical Education Online, 2009
- Contributions of a Local Health Examination Survey to the Surveillance of Chronic and Infectious Diseases in New York CityAmerican Journal of Public Health, 2009
- A good death certificate: improved performance by simple educational measuresPublished by Oxford University Press (OUP) ,2007
- Improving Death Certificate Completion: A Trial of Two Training InterventionsJournal of General Internal Medicine, 2007
- Validation of death certificate diagnosis for coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) StudyJournal of Clinical Epidemiology, 2001
- Death certification: production and evaluation of a training videoMedical Education, 1996
- Protocol for Writing Cause-of-Death Statements for Deaths Due to Natural CausesArchives of Internal Medicine, 1996
- Comparisons of cause of death verification methods and costs in the lipid research clinics program mortality follow-up studyControlled Clinical Trials, 1989
- The Autopsy as a Measure of Accuracy of the Death CertificateNew England Journal of Medicine, 1985