基于国际疾病分类围产期死亡率(ICD-PM)改进死亡证明书病因记录:混合方法的影响
Improving the Documentation of Causes of Death Certificates Based on the International Classification of Diseases Perinatal Mortality (ICD-PM): The Impact of a Mixed Method Approach.
作者信息
Jafari Masoumeh, Meraji Marziyhe, Tehrani Hadi, Mirteimouri Masoumeh, Heidarzadeh Mohammad
机构信息
Health Information Management, Department of Health Information Technology, School of Paramedical Sciences Mashhad University of Medical Sciences Mashhad Iran.
Department of Health Education and Health Promotion, Social Determinants of Health Research Center Mashhad University of Medical Sciences Mashhad Iran.
出版信息
Health Sci Rep. 2025 May 26;8(5):e70845. doi: 10.1002/hsr2.70845. eCollection 2025 May.
BACKGROUND AND AIMS
To reduce the number of preventable perinatal deaths, the first step is to identify their causes, the World Health Organization (WHO) has developed the International Classification of Diseases Perinatal Mortality (ICD-PM) system for this purpose. The objective of the study was to investigate improving the documentation of causes of death certificates using the ICD-PM.
METHOD
The present study is a mixed-method study that encompasses a multifaceted intervention in Iran, conducted in four distinct stages: (a) data collection pertaining to the causes of perinatal deaths pre-intervention, (b) delivery of ICD-PM education to physicians through both face-to-face and virtual sessions, (c) data collection pertaining to the causes of perinatal deaths post- intervention, and (d) comparison of the documentation of perinatal mortality causes pre and post-intervention. The data analysis is executed using the Statistical Package for the Social Sciences (SPSS) software.
RESULTS
Comparing the results of pre and post-intervention reveals a significant increase in the percentage of correctly identifying the cause of perinatal mortality, from 19.5% to 39% ( < 0.001). Furthermore, there was a substantial increase in the percentage of maternal conditions identified, from 13% to 60.9% ( < 0.045). Additionally, the percentage of perinatal mortality cases with unknown causes decreased considerably, from 72% to 21.9% ( < 0.05).
CONCLUSION
The study found that training on ICD-PM for physicians improves their ability to identify the causes of perinatal mortality and maternal conditions. This approach can reduce cases with unknown causes and improve the accuracy of documenting and classifying perinatal mortality causes. These findings can inform interventions to prevent avoidable perinatal deaths.
背景与目的
为减少可预防的围产期死亡数量,首要步骤是确定其原因,世界卫生组织(WHO)为此开发了国际疾病分类围产期死亡率(ICD - PM)系统。本研究的目的是调查使用ICD - PM改进死亡证明书中死因记录的情况。
方法
本研究是一项混合方法研究,在伊朗进行了多方面干预,分四个不同阶段进行:(a)干预前收集围产期死亡原因的数据;(b)通过面对面和虚拟课程向医生提供ICD - PM教育;(c)干预后收集围产期死亡原因的数据;(d)比较干预前后围产期死亡率原因的记录情况。使用社会科学统计软件包(SPSS)软件进行数据分析。
结果
干预前后结果对比显示,正确识别围产期死亡原因的百分比显著增加,从19.5%增至39%(<0.001)。此外,确定的孕产妇疾病百分比大幅增加,从13%增至60.9%(<0.045)。另外,原因不明的围产期死亡病例百分比大幅下降,从72%降至21.9%(<0.05)。
结论
研究发现,对医生进行ICD - PM培训可提高他们识别围产期死亡原因和孕产妇疾病的能力。这种方法可减少原因不明的病例,提高围产期死亡率原因记录和分类的准确性。这些发现可为预防可避免的围产期死亡的干预措施提供参考。