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The system to collect information on mortality statistics in Lao PDR is not well established, accurate and timely death information is therefore not available. This article reports the system and process to make the mortality statistical data of Lao PDR. The country has a paper-based resident registration system, using a death notification document, a death certificate, and a family census book. The death notification document is important as it provides the cause of death, which is issued from a health facility and the village office. In the event of a death occurring at home, the family representative needs to report to the village office verbally to obtain a death notification document. On the other hand, if the death occurred in a medical facility, a death notification document from a health facility is provided. The family representative should bring the death notification document to the district Home Affairs office to register the death and obtain a death certificate. After that, the family representative needs to bring the death certificate to the district Public Security office for an amendment in the family census book. ICD-10 is under development regarding death notification from health facilities under the Ministry of Health. However, it is unclear how death notification from village offices can adopt ICD-10 as the majority of deaths occur outside health facilities. A comprehensive and integrated mortality reporting system is necessary in order to create a holistic health policy and welfare for the country.

The system to collect information on mortality statistics in Lao PDR is not well established, accurate and timely death information is therefore not available. This article reports the system and process to make the mortality statistical data of Lao PDR. The country has a paper-based resident registration system, using a death notification document, a death certificate, and a family census book. The death notification document is important as it provides the cause of death, which is issued from a health facility and the village office. In the event of a death occurring at home, the family representative needs to report to the village office verbally to obtain a death notification document. On the other hand, if the death occurred in a medical facility, a death notification document from a health facility is provided. The family representative should bring the death notification document to the district Home Affairs office to register the death and obtain a death certificate. After that, the family representative needs to bring the death certificate to the district Public Security office for an amendment in the family census book. ICD-10 is under development regarding death notification from health facilities under the Ministry of Health. However, it is unclear how death notification from village offices can adopt ICD-10 as the majority of deaths occur outside health facilities. A comprehensive and integrated mortality reporting system is necessary in order to create a holistic health policy and welfare for the country.

Objective: Obtaining accurate data about causes of death may be difficult in patients with a complicated disease history, including cancer survivors. This study compared causes of death derived from medical records (CODMR) with causes of death derived from death certificates (CODDC) as processed by Statistics Netherlands of patients primarily treated for Hodgkin lymphoma (HL) or breast cancer (BC). Methods: Two hospital-based cohorts comprising 1,215 HL patients who died in

Background: After the return of democracy to Spain and the assumption of governmental powers by the regional areas, measures were taken to improve cause-of-death statistics. The objective of this study was to describe the evolution of the activities undertaken to improve the quality of mortality statistics in the region of Murcia from 1998 to 2011. Methods: A descriptive epidemiological study of all the death documentation processed by the mortality registry in Murcia. Relative quality indicators were used to evaluate the fulfilment of documentation by doctors and court staff. This was backed up by information recovery regarding the causes and circumstances of death, and evaluating the impact on the mortality statistics of ill-defined, unspecific and less specific causes. Results: During the study-period, lack of temporal sequence on the medical death certificate reduced from an initial 46% to a final 21% (p<0.001). Retrieval of information from the various sources was successful in 93% of cases in 2001 compared with 38% at the start of the period (p<0.001). Regional rates of ill-defined and less specific causes have reduced more than the national Spanish rates, with a difference of 10.3 (p<0.001) and 2.8 points (p=0.001), respectively. Conclusions: Medical certification of death has improved both form and suitability. The regulated recovery of the causes and circumstances of death corrected medical and judicial information. Murcia presented lower age-adjusted death rates of less specific and ill-defined causes than the national average., RESUMEN Fundamentos: Tras el retorno de España a la democracia y la asunción regional de competencias gubernamentales, se iniciaron actuaciones de mejora de la estadística de causas de muerte. El objetivo de este trabajo fue describir la evolución de las actividades de mejora de la calidad en la estadística de mortalidad en la región de Murcia de 1998 a 2011. Métodos: Estudio epidemiológico descriptivo de todos los documentos de defunción procesados por el registro de mortalidad de Murcia. Dentro de este estudio se incluyen el uso de indicadores relativos a la calidad de la cumplimentación de documentos por médicos y juzgados, la recuperación de información sobre las causas y circunstancias de la muerte, y el impacto en la estadística de las causas mal definidas, inespecíficas y poco específicas. Resultados: Durante el periodo de estudio, la notificación médica sin secuencia temporal en el certificado de defunción ha disminuido del 46% inicial al 21% final (p<0,001). La recuperación de información de las fuentes resultó exitosa en el 93% de los casos en 2001 comparada con el 38% al principio del periodo (p<0,001). Las tasas regionales de las causas mal definidas y poco específicas descendieron más que las nacionales, y se situaron en el último año con un diferencial de 10,3 (p<0,001) y 2,8 puntos (p=0,001), respectivamente. Conclusiones: La certificación médica de la defunción mejoró en forma e idoneidad. La recuperación reglada de las causas y circunstancias de la muerte corrigió la información médica y judicial. La región de Murcia presentó menores tasas ajustadas por causas poco específicas y entidades mal definidas que el promedio nacional.

Background: There may be various reasons for differences in suicide rates between countries and over time within a country. One reason can be different registration practices. Aims: The purpose of this study was to describe and compare the present procedures for mortality and suicide registration in the three Scandinavian countries and to illustrate potential sources of error in the registration of suicide. Method: Information about registration practices and classification procedures was obtained from the cause of death registers in Norway, Sweden, and Denmark. In addition, we received information from experts in the field in each country. Results: Sweden uses event of undetermined intent more frequently than Denmark does, and Denmark more frequently than Norway. There seems to be somewhat more uncertainty among deaths classified as ill-defined and unknown cause of mortality in Norway, compared with the other two countries. Sweden performs more forensic autopsies than Norway, and Norway more than Denmark. In Denmark, in cases of a suspected unnatural manner of death, a thorough external examination of the deceased is performed. Conclusion: Differences in the classification of causes of death and in postmortem examinations exist in Scandinavian countries. These differences might influence the suicide statistics in Scandinavia.

OBJECTIVE: This study investigates whether changes in registration and coding practices influenced official suicide rates in Norway from 1988 to 2002. STUDY DESIGN AND SETTING: A Poisson regression model was used to evaluate rates of suicide and potentially competing underlying causes of death. Setting in Norway 1988-2002. RESULTS: From 1988 to 1994, suicide mortality decreased significantly, by 23.7%. Simultaneously, rates of causes of death potentially masking suicide decreased or remained fairly stable. From 1994 to 2002, however, there were no significant changes in suicide rates but accidental poisoning, which may mask suicide, increased significantly by 32.4%. Also, "ill-defined causes" of death increased by 16.7%, indicating poorer data quality. CONCLUSION: This study suggests that the decreasing suicide rate in 1988-94 reflects a real change. However, the general quality of mortality statistics has deteriorated since the late 1990s, making it difficult to assess developments since 1994. Such variations in the reliability of official suicide statistics complicate international comparisons. However, shifts in the death rate because of "ill-defined" causes could serve as a warning that data quality is not consistent over time.

OBJECTIVE: Mortality statistics are important for epidemiological research. We examine if discrepancies between death certificate (DC) and hospital discharge condition (HDC) indicate certification errors. STUDY DESIGN AND SETTING: From 39,872 hospital deaths in Sweden in 1995, we randomly selected 600 "cases," where DC and HDC were incompatible, and 600 compatible "controls," matched on sex, age, and underlying cause of death. We obtained case summaries for 1,094 (91%) of these. Using a structured protocol, we assessed the accuracy of DCs. RESULTS: Regression analysis indicated diagnostic group and "case" or "control" as the variables that most affected the accuracy. Malignant neoplasm "controls" had the highest accuracy (92%), and benign and unspecified tumor "cases," the lowest (20%). For all diagnostic groups except one, compatible "controls" had better accuracy than incompatible "cases." The exception, chronic obstructive lung disease, had low accuracy for both "cases" (54%) and "controls" (52%). CONCLUSION: Incompatibility between DC and HDC indicates a greater risk of certification errors. For some diagnostic groups, however, DCs are often inaccurate even when DC and HDC are compatible. By requesting additional information on incompatible cases and all deaths in high-risk diagnostic groups, producers of mortality statistics could improve the accuracy of the statistics.

Mortality statistics are much used although their accuracy is often questioned. Producers of mortality statistics check for errors in death certification but current methods only capture obvious mistakes. This thesis investigates whether non-obvious errors can be found by linking death certificates to hospital discharge data. Data: 69,818 deaths in Sweden 1995. Paper I: Analysing differences between the underlying cause of death from the death certificate (UC) and the main discharge condition from the patient’s last hospitalization (MDC). Paper II: Testing whether differences can be explained by ICD definitions of UC and MDC. Paper III: Surveying methods in 44 current studies on the accuracy of death certificates. Paper IV: Checking death certificates against case summaries for: i) 573 deaths where UC and MDC were the same or the difference could be explained; ii) 562 deaths where the difference could not be explained. Results: In 54% of deaths the MDC differed from the UC. Almost two-thirds of the differences were medically compatible since the MDC might have developed as a complication of the UC. Of 44 recent evaluation studies, only 8 describe the methods in such detail that the study could be replicated. Incompatibility between MDC and UC indicates a four-fold risk that the death certificate is inaccurate. For some diagnostic groups, however, death certificates are often inaccurate even when the UC and MDC are compatible. Conclusion: Producers of official mortality statistics could reduce the number of non-obvious errors in the statistics by collecting additional information on incompatible deaths and on deaths in high-risk diagnostic groups. ICD conventions contribute to the quality problem since they presuppose that all deaths are due to a single underlying cause. However, in an ageing population an increasing number of deaths are due to an accumulation of etiologically unrelated conditions.

Mortality statistics are much used although their accuracy is often questioned. Producers of mortality statistics check for errors in death certification but current methods only capture obvious mistakes. This thesis investigates whether non-obvious errors can be found by linking death certificates to hospital discharge data. Data: 69,818 deaths in Sweden 1995. Paper I: Analysing differences between the underlying cause of death from the death certificate (UC) and the main discharge condition from the patient’s last hospitalization (MDC). Paper II: Testing whether differences can be explained by ICD definitions of UC and MDC. Paper III: Surveying methods in 44 current studies on the accuracy of death certificates. Paper IV: Checking death certificates against case summaries for: i) 573 deaths where UC and MDC were the same or the difference could be explained; ii) 562 deaths where the difference could not be explained. Results: In 54% of deaths the MDC differed from the UC. Almost two-thirds of the differences were medically compatible since the MDC might have developed as a complication of the UC. Of 44 recent evaluation studies, only 8 describe the methods in such detail that the study could be replicated. Incompatibility between MDC and UC indicates a four-fold risk that the death certificate is inaccurate. For some diagnostic groups, however, death certificates are often inaccurate even when the UC and MDC are compatible. Conclusion: Producers of official mortality statistics could reduce the number of non-obvious errors in the statistics by collecting additional information on incompatible deaths and on deaths in high-risk diagnostic groups. ICD conventions contribute to the quality problem since they presuppose that all deaths are due to a single underlying cause. However, in an ageing population an increasing number of deaths are due to an accumulation of etiologically unrelated conditions.

Mortality statistics are much used although their accuracy is often questioned. Producers of mortality statistics check for errors in death certification but current methods only capture obvious mistakes. This thesis investigates whether non-obvious errors can be found by linking death certificates to hospital discharge data. Data: 69,818 deaths in Sweden 1995. Paper I: Analysing differences between the underlying cause of death from the death certificate (UC) and the main discharge condition from the patient’s last hospitalization (MDC). Paper II: Testing whether differences can be explained by ICD definitions of UC and MDC. Paper III: Surveying methods in 44 current studies on the accuracy of death certificates. Paper IV: Checking death certificates against case summaries for: i) 573 deaths where UC and MDC were the same or the difference could be explained; ii) 562 deaths where the difference could not be explained. Results: In 54% of deaths the MDC differed from the UC. Almost two-thirds of the differences were medically compatible since the MDC might have developed as a complication of the UC. Of 44 recent evaluation studies, only 8 describe the methods in such detail that the study could be replicated. Incompatibility between MDC and UC indicates a four-fold risk that the death certificate is inaccurate. For some diagnostic groups, however, death certificates are often inaccurate even when the UC and MDC are compatible. Conclusion: Producers of official mortality statistics could reduce the number of non-obvious errors in the statistics by collecting additional information on incompatible deaths and on deaths in high-risk diagnostic groups. ICD conventions contribute to the quality problem since they presuppose that all deaths are due to a single underlying cause. However, in an ageing population an increasing number of deaths are due to an accumulation of etiologically unrelated conditions.

Mortality statistics are much used although their accuracy is often questioned. Producers of mortality statistics check for errors in death certification but current methods only capture obvious mistakes. This thesis investigates whether non-obvious errors can be found by linking death certificates to hospital discharge data. Data: 69,818 deaths in Sweden 1995. Paper I: Analysing differences between the underlying cause of death from the death certificate (UC) and the main discharge condition from the patient’s last hospitalization (MDC). Paper II: Testing whether differences can be explained by ICD definitions of UC and MDC. Paper III: Surveying methods in 44 current studies on the accuracy of death certificates. Paper IV: Checking death certificates against case summaries for: i) 573 deaths where UC and MDC were the same or the difference could be explained; ii) 562 deaths where the difference could not be explained. Results: In 54% of deaths the MDC differed from the UC. Almost two-thirds of the differences were medically compatible since the MDC might have developed as a complication of the UC. Of 44 recent evaluation studies, only 8 describe the methods in such detail that the study could be replicated. Incompatibility between MDC and UC indicates a four-fold risk that the death certificate is inaccurate. For some diagnostic groups, however, death certificates are often inaccurate even when the UC and MDC are compatible. Conclusion: Producers of official mortality statistics could reduce the number of non-obvious errors in the statistics by collecting additional information on incompatible deaths and on deaths in high-risk diagnostic groups. ICD conventions contribute to the quality problem since they presuppose that all deaths are due to a single underlying cause. However, in an ageing population an increasing number of deaths are due to an accumulation of etiologically unrelated conditions.

Mortality statistics are much used although their accuracy is often questioned. Producers of mortality statistics check for errors in death certification but current methods only capture obvious mistakes. This thesis investigates whether non-obvious errors can be found by linking death certificates to hospital discharge data. Data: 69,818 deaths in Sweden 1995. Paper I: Analysing differences between the underlying cause of death from the death certificate (UC) and the main discharge condition from the patient’s last hospitalization (MDC). Paper II: Testing whether differences can be explained by ICD definitions of UC and MDC. Paper III: Surveying methods in 44 current studies on the accuracy of death certificates. Paper IV: Checking death certificates against case summaries for: i) 573 deaths where UC and MDC were the same or the difference could be explained; ii) 562 deaths where the difference could not be explained. Results: In 54% of deaths the MDC differed from the UC. Almost two-thirds of the differences were medically compatible since the MDC might have developed as a complication of the UC. Of 44 recent evaluation studies, only 8 describe the methods in such detail that the study could be replicated. Incompatibility between MDC and UC indicates a four-fold risk that the death certificate is inaccurate. For some diagnostic groups, however, death certificates are often inaccurate even when the UC and MDC are compatible. Conclusion: Producers of official mortality statistics could reduce the number of non-obvious errors in the statistics by collecting additional information on incompatible deaths and on deaths in high-risk diagnostic groups. ICD conventions contribute to the quality problem since they presuppose that all deaths are due to a single underlying cause. However, in an ageing population an increasing number of deaths are due to an accumulation of etiologically unrelated conditions.

Prevalence of smoking in Chile The findings of the surveys carried out by the National Drug Control Council (CONACE), which have been conducted every two years from 1994 to 2000, are the most reliable source of data on drug consumption in Chile.

Prevalence of smoking in Chile The findings of the surveys carried out by the National Drug Control Council (CONACE), which have been conducted every two years from 1994 to 2000, are the most reliable source of data on drug consumption in Chile.

Prevalence of smoking in Chile The findings of the surveys carried out by the National Drug Control Council (CONACE), which have been conducted every two years from 1994 to 2000, are the most reliable source of data on drug consumption in Chile.

This paper contains a summary of the sanitary conditions in Mexico at the present time and concludes that it would be a menace to the health of any military command invading the country, including mortality statistics for 1925-1930.