Thanigasalam Abinavsharvesh, Ramu Ramadoss, Rajarethinam Kanagarethinam
Medical Records Department, †Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Indian J Med Res. 2025 Apr;161(4):420-424. doi: 10.25259/IJMR_1394_2024.
Background & objectives Mortality statistics are crucial for understanding public health. Accurate medical certification of cause of death (MCCD) is essential for good mortality statistics. However, the quality of MCCD form-filling remains a concern. Based on the learnings from the ICMR-National Centre for Disease Informatics and Research (ICMR-NCDIR), e-Mortality software implementation project, our institute developed and used a new in-house mortality software for MCCD from January 2021. This study compared MCCD forms before and after implementation of the mortality software. Methods The study was conducted from March 2024 to July 2024 in the department of Medicine at a tertiary care teaching institute in Puducherry. We analysed 105 hand-written forms from the year 2020 and 105 software-generated forms from the year 2021, focusing on completeness, errors, and International Classification of Diseases-10 (ICD-10) compatibility. We checked 13 items for completeness. Errors were categorised as major or minor, depending on how they affected ICD-10 coding. Results The proportion of completeness improved from 4 to 19 per cent after software introduction (P<0.001). Minor errors significantly decreased from 96 to 81 per cent (P<0.002). About 88 per cent of hand-written forms had major errors, which was significantly reduced to 42 per cent in software-generated forms (P<0.001). Compatibility of the underlying cause of death for generating ICD-10 coding improved from 73 to 96 per cent (P<0.001). Interpretation & conclusions The findings of this study suggest that our mortality software significantly improved completeness and modestly reduced errors. Other institutions may consider adopting an electronic format for MCCD to improve completeness and accuracy. We emphasise regular training of doctors and auditing of MCCD forms to further improve the quality of death certification.
背景与目的 死亡率统计对于理解公共卫生至关重要。准确的死因医学认证（MCCD）对于良好的死亡率统计至关重要。然而，MCCD表格填写的质量仍然令人担忧。基于从印度医学研究理事会 - 国家疾病信息与研究中心（ICMR - NCDIR）的电子死亡率软件实施项目中学到的经验，我们机构于2021年1月开发并使用了一种新的内部死亡率软件用于MCCD。本研究比较了死亡率软件实施前后的MCCD表格。方法 该研究于2024年3月至2024年7月在本地治里一所三级护理教学机构的医学系进行。我们分析了2020年的105份手写表格和2021年的105份软件生成的表格，重点关注完整性、错误以及国际疾病分类第10版（ICD - 10）兼容性。我们检查了13项内容的完整性。根据错误对ICD - 10编码的影响程度，将错误分为重大错误或轻微错误。结果 引入软件后，完整性比例从4%提高到了19%（P<0.001）。轻微错误从96%显著下降到81%（P<0.002）。约88%的手写表格存在重大错误，在软件生成的表格中这一比例显著降至42%（P<0.001）。用于生成ICD - 10编码的根本死因兼容性从73%提高到了96%（P<0.001）。解读与结论 本研究结果表明，我们的死亡率软件显著提高了完整性并适度减少了错误。其他机构可能会考虑采用MCCD的电子格式以提高完整性和准确性。我们强调定期对医生进行培训并对MCCD表格进行审核，以进一步提高死亡证明的质量。
