Department of Community Health and Psychiatry, University of the West Indies, 3 Gibraltar Camp Way, Mona, Kingston 7, Jamaica.
International Biostatistics and Information Services, Anse O'Quille, Marisule, Gros Islet, St Lucia.
J Clin Epidemiol. 2015 Sep;68(9):979-87. doi: 10.1016/j.jclinepi.2014.11.026. Epub 2015 Feb 7.
Describe the completeness and quality of Jamaica's 2008 vital registration mortality database.
Multiple sources (hospitals, police, forensic pathologists, Coroners courts) were used to validate deaths registered as occurring in 2008. A 10% random sample was examined to evaluate the quality of certification and coding. Jamaica, a middle-income country of 2.7 million, began vital registration in 1877; however, the mortality database was considered of limited use, and the study was commissioned to understand the problem.
Of 19,286 deaths identified, 76% were registered by 31.12.2009 for inclusion among 2008 demographic returns. Registration was highest among deaths not requiring autopsy (94%) and lowest among Coroners cases (22%) with only 41% of deaths among 15-44 year-olds registered. The leading causes of death were cerebrovascular disease, diabetes mellitus, and homicide. Fifteen percent were coded to ill-defined causes of death. Recoding the sample increased mortality from prematurity, pregnancy complications, homicide, selected cardiovascular disorders, and human immunodeficiency virus/AIDS.
Delays registering Coroners cases, certification and coding errors, introduced biases into the disease profile limiting the data's value in informing clinical care. Issuance of medical certificates by pathologists who investigate Coroners cases and training physicians and coders would eliminate most underreporting and improve data quality.
描述牙买加 2008 年生命登记死亡率数据库的完整性和质量。
利用多个来源（医院、警察、法医病理学家、验尸官法庭）对登记为 2008 年发生的死亡进行验证。检查了 10%的随机样本，以评估认证和编码的质量。牙买加是一个拥有 270 万人口的中等收入国家，于 1877 年开始进行生命登记；然而，由于该死亡率数据库的实用性有限，因此委托进行了这项研究，以了解存在的问题。
在确定的 19286 例死亡中，有 76%是在 2009 年 12 月 31 日前登记的，以便列入 2008 年人口统计报告。无需进行尸检的死亡登记率最高（94%），验尸官案件最低（22%），只有 41%的 15-44 岁人群的死亡得到登记。主要死亡原因是脑血管疾病、糖尿病和凶杀。15%的死因被编码为死因不明。对样本进行重新编码增加了因早产、妊娠并发症、凶杀、某些心血管疾病和人类免疫缺陷病毒/艾滋病导致的死亡率。
延迟登记验尸官案件、认证和编码错误会给疾病概况引入偏差，从而限制了数据在为临床护理提供信息方面的价值。由调查验尸官案件的病理学家发放医疗证明，并对医生和编码员进行培训，将消除大多数漏报现象并提高数据质量。
