Research Unit, Palestinian National Institute of Public Health, Ramallah, Palestine.
Research Unit, Deputy Minister Office, Ministry of Health, Ramallah, Palestine.
BMJ Open. 2019 Apr 20;9(4):e026640. doi: 10.1136/bmjopen-2018-026640.
To examine the accuracy of mortality statistics in Palestine, to identify gaps and to provide evidence-based recommendations to improve mortality statistics in Palestine.
A retrospective death registry-based study that examined a stratified random sample of death notification forms (DNFs) of patients who died in hospitals in Palestine was reported in 2012. We randomly selected 600 deceased from the Cause of Death Registry: 400 from the West Bank and 200 from the Gaza Strip. Analysis was based on the randomly selected deaths that we were able to retrieve the medical records for; 371 deaths in the West Bank and 199 deaths in the Gaza Strip.
Data in the Palestinian Health Information Centre (PHIC) registry had a low degree of accuracy: less than half of the underlying causes stated the correct cause of death. In general, deaths due to malignant neoplasms were more accurately reported on DNFs than other causes of death, and metabolic diseases (including diabetes) were the most problematic. Issues with coding and classification at the PHIC were most apparent for perinatal conditions and congenital anomalies.
Procedures for coding and classification at the PHIC deviate considerably from the international norms defined in the International Statistical Classification of Diseases and Related Health Problems (ICD) and account to a considerable extent for the discrepancies between the cause of death determined on the medical data on the death extracted from the deceased patient's hospital records and the cause of death coded by the PHIC. We recommend the introduction of international coding software for coding and classification, and a review to improve data handling in hospitals, especially those with electronic patient records.
检查巴勒斯坦死亡率统计数据的准确性，找出差距，并提供基于证据的建议，以改善巴勒斯坦的死亡率统计数据。
这是一项回顾性死亡登记研究，于 2012 年报告了对在巴勒斯坦医院死亡的患者死亡通知表（DNF）的分层随机样本进行的检查。我们从死因登记处随机抽取了 600 名死者：西岸 400 名，加沙地带 200 名。分析基于我们能够检索到病历的随机选择的死亡人数；西岸有 371 人死亡，加沙地带有 199 人死亡。
巴勒斯坦健康信息中心（PHIC）登记处的数据准确性较低：不到一半的根本原因陈述了正确的死亡原因。一般来说，DNF 对恶性肿瘤死亡的报告比其他死亡原因更准确，而代谢疾病（包括糖尿病）是最成问题的。PHIC 编码和分类方面的问题在围产期情况和先天畸形方面最为明显。
PHIC 的编码和分类程序与《国际疾病分类和相关健康问题统计分类》（ICD）定义的国际规范有很大差异，并且在很大程度上解释了从死者医院记录中提取的死亡医疗数据确定的死亡原因与 PHIC 编码的死亡原因之间的差异。我们建议引入国际编码软件进行编码和分类，并审查以改善医院的数据处理，特别是那些具有电子病历的医院。
