Leitch D G, Heller R F, O'Connor S J
University of Newcastle, NSW.
Aust N Z J Med. 1987 Jun;17(3):309-15. doi: 10.1111/j.1445-5994.1987.tb01234.x.
This study was designed to test the hypothesis that the between-State variation in death rates from ischemic heart disease may be due in part to variation in the manner in which death certificates are completed or the diagnoses on them are assigned numerical codes. Random samples of 75 doctors who had recently completed a death certificate in an Australian State or in Auckland, New Zealand, as well as all doctors who had recently completed a death certificate in the Northern Territory were asked to participate. They were sent a book of 10 actual case histories and asked to complete a death certificate for each case. Seventy per cent of the doctors returned death certificates (range from 64% to 81%). Each certificate was coded by the Australian Bureau of Statistics (ABS) in the doctor's State of residence, or by the New Zealand Health Statistics Centre for Auckland respondents, and then coded again by the federal office of the ABS in Canberra. There was considerable variation in the codes assigned to each case history but systematic variation large enough to account for the variation in between-State ischemic heart disease death rates was not seen. There was little systematic variation between codes assigned in each State and by the federal ABS office, although a few isolated discrepancies were identified which need attention by the ABS.(ABSTRACT TRUNCATED AT 250 WORDS)
缺血性心脏病死亡率的州际差异可能部分归因于死亡证明填写方式的差异，或其上诊断被赋予数字编码的方式的差异。我们邀请了75名最近在澳大利亚某州或新西兰奥克兰填写过死亡证明的医生的随机样本，以及所有最近在北领地填写过死亡证明的医生参与研究。我们给他们寄去了一本包含10个实际病例史的册子，并要求他们为每个病例填写一份死亡证明。70%的医生寄回了死亡证明（回复率从64%到81%不等）。每份证明由澳大利亚统计局（ABS）在医生居住州进行编码，奥克兰的受访者则由新西兰卫生统计中心编码，然后再由堪培拉的ABS联邦办公室进行编码。每个病例史所分配的编码存在相当大的差异，但未发现足以解释州际缺血性心脏病死亡率差异的系统性差异。每个州所分配的编码与ABS联邦办公室所分配的编码之间几乎没有系统性差异，不过发现了一些个别差异，ABS需要予以关注。（摘要截选至250词）
