Abstract

VANDERLEI, Lygia Carmen; ARRUDA, Bertoldo Kruse Grande de; FRIAS, Paulo Germano de  and  ARRUDA, Suely. Reliability evaluation of reported underlying causes of death at a terciary service of mother and child health care. Inf. Epidemiol. Sus [online]. 2002, vol.11, n.1, pp.15-23. ISSN 0104-1673.  http://dx.doi.org/10.5123/S0104-16732002000100003.

Numerous studies based on the review of medical records highlight the inaccuracy of reported underlying cause(s) of death, despite the implementation of the Mortality Information System (MIS) in Brazil since 1975. The objective of this study was to evaluate the reliability of underlying cause(s) of death registered in the original death certificate (DC) comparing them with corrected defined causes obtained in medical records of the first semester of 1999. The study was carried out at an institution after the implementation of the Hospital Epidemiology Unit (HEU). Observed concordance and kappa index were used. The study showed that doctors do not routinely incorporate the concept of underlying cause of death. Diagnosis of infection, prematurity and hypoxia, which ignore an understanding of the determinant factors of death, were overestimated. The implementation of HEU is suggested as a strategy to improve the systematic and timely data collection and to assure training of the clinical staff at the health service. These actions can enhance medical knowledge about the clinician´s role as the initial link in the chain of information about vital events and contribute towards the improvement of the MIS by monitoring the quality of DC at the hospital level.

Keywords : Infant Mortality; Underlying Cause of Death; Information System; Quality Evaluation.

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