Quality of cause-of-death data in Brazil: Garbage codes among registered deaths in 2000 and 2015

Teixeira, Renato Azeredo; Naghavi, Mohsen; Guimarães, Mark Drew Crosland; Ishitani, Lenice Harumi; França, Elisabeth Barboza

doi:10.1590/1980-549720190002.supl.3

Cited by 38 publications

(43 citation statements)

References 21 publications

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“…Although the relationship between SDI and rates was maintained in 2006-2016, rates of level 1-2 GCs in the three different state groups converged over time, indicating reduced inequalities in data quality due to major GCs. This reduction may have been related to the intervention of the MoH focused on poorer areas, and therefore leading to a reduction in those codes [6].…”

Section: Discussionmentioning

confidence: 99%

“…The intervention of the MoH implemented in Brazilian states in 2005—the investigation of GC level 1 R-codes, responsible for a higher proportion of GCs in the country (14.3% out of 946,960 deaths recorded at SIM in 2000), impacted on reducing those codes and improved the quality of cause of death data [ 6 ]. To control for the effect of this confounding factor in time series analysis of socioeconomic differences, we considered two separate periods in this analysis, 1996–2005 and 2006–2016.…”

Section: Methodsmentioning

confidence: 99%

“…A national official intervention by the Ministry of Health (MoH) was started in 2005 to investigate ill-defined causes of death in health facilities and at home in the whole country, particularly in the poorest North and Northeast regions [5]. Reported results indicate that this investigation has been effective [6].…”

Section: Introductionmentioning

confidence: 99%

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Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016

França

Ishitani

Teixeira

et al. 2020

Popul Health Metrics

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Background Registered causes in vital statistics classified as garbage codes (GC) are considered indicators of quality of cause-of-death data. Our aim was to describe temporal changes in this quality in Brazil, and the leading GCs according to levels assembled for the Global Burden of Disease (GBD) study. We also assessed socioeconomic differences in the burden of different levels of GCs at a regional level. Methods We extracted data from the Brazilian Mortality Information System from 1996 to 2016. All three- and four-digit ICD-10 codes considered GC were selected and classified into four categories, according to the GBD study proposal. GC levels 1 and 2 are the most damaging unusable codes, or major GCs. Proportionate distribution of deaths by GC levels according selected variables were performed. Age-standardized mortality rates after correction of underreporting of deaths were calculated to investigate temporal relationships as was the linear association adjusted for completeness between GC rates in states and the Sociodemographic Index (SDI) from the GBD study, for 1996–2005 and 2006–2016. We classified Brazilian states into three classes of development by applying tertiles cutoffs in the SDI state-level estimates. Results Age-standardized mortality rates due to GCs in Brazil decreased from 1996 to 2016, particularly level 1 GCs. The most important GC groups were ill-defined causes (level 1) in 1996, and pneumonia unspecified (level 4) in 2016. At state level, there was a significant inverse association between SDI and the rate of level 1–2 GCs in 1996–2005, but both SDI and completeness had a non-expected significant direct association with levels 3–4. In 2006–2016, states with higher SDIs tended to have lower rates of all types of GCs. Mortality rates due to major GCs decreased in all three SDI classes in 1996–2016, but GC levels 3–4 decreased only in the high SDI category. States classified in the low or medium SDI groups were responsible for the most important decline of major GCs. Conclusion Occurrence of major GCs are associated with socioeconomic determinants over time in Brazil. Their reduction with decreasing disparity in rates between socioeconomic groups indicates progress in reducing inequalities and strengthening cause-of-death statistics in the country.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016

França

Ishitani

Teixeira

et al. 2020

Popul Health Metrics

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show abstract

“…A national o cial intervention by the Ministry of Health (MoH) was started in 2005 to investigate ill-de ned causes of death in health facilities and at home in the whole country, particularly in the poorest North and Northeast regions [5]. Reported results indicate that this investigation has been effective [6].…”

Section: Introductionmentioning

confidence: 99%

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996-2016

França

Ishitani

Teixeira

et al. 2020

Preprint

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Background: Registered causes in vital statistics classified as garbage codes (GC) are considered indicators of quality of cause-of-death data. Our aim was to describe temporal changes in this quality in Brazil, and the leading GCs according to levels assembled for the Global Burden of Disease (GBD) study. We also assessed socioeconomic differences in the burden of different levels of GCs at a regional level. Methods: We extracted data from the Brazilian Mortality Information System from 1996 to 2016. All three and four digit ICD-10 codes considered as GC were selected and classified into four categories, according to the GBD study proposal. GCs levels 1 and 2 are the most damaging unusable codes, or major GCs. Proportionate distribution of deaths by GC levels according selected variables were performed. Age-standardized mortality rates after correction of underreporting of deaths were calculated to investigate temporal relationships as was the linear association adjusted for completeness between GC rates in states and the Sociodemographic Index (SDI) from the GBD study, for 1996-2005 and 2006-2016. We classified Brazilian states into three classes of development by applying tertiles cutoffs in the SDI state‐level estimates. Results: Age-standardized mortality rates due to GCs in Brazil decreased from 1996 to 2016, particularly level 1 GCs. The most important GC groups were ill-defined causes (level 1) in 1996, and pneumonia unspecified (level 4) in 2016. At state level, there was a significant inverse association between SDI and the rate of level 1-2 GCs in 1996-2005, but both SDI and completeness had a non-expected significant direct association with levels 3-4. In 2006-2016, states with higher SDIs tended to have lower rates of all types of GCs. Mortality rates due to major GCs decreased in all three SDI classes in 1996-2016, but GCs levels 3-4 decreased only in the high SDI category. States classified in the low or medium SDI groups were responsible for the most important decline of major GCs. Conclusion: Occurrence of major GCs are associated with socioeconomic determinants over time in Brazil. Their reduction with decreasing disparity in rates between socioeconomic groups indicates progress in reducing inequalities and strengthening cause-of-death statistics in the country.

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“…(12) However, improvement over the years has reduced these differences. (13)(14)(15) In 2017, injuries were the cause of 158,658 deaths in Brazil. Over one-quarter of the original cause for these deaths was a GC.…”

Section: Introductionmentioning

confidence: 99%

Improving the quality of external cause of death data in Brazil: evaluation and validation of a new form to investigate garbage codes

Filho

Lima

Merchán-Hamann

et al. 2020

Preprint

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Background: Accurate cause of death (COD) data are essential for policy and planning. Garbage codes (GCs), such as external causes with no further specific information, are commonly used as an indicator of poor quality of COD information. The investigation of GC using an effective instrument is necessary to convert them into useful data for public health. Aim: This study was conducted to analyze the effectiveness of the new investigation of deaths from external causes (IDEC) form, proposed by Ministry of Health, Brazil, to improve the quality of COD. Methods: The study compared the performance of the IDEC form on 164 external GC deaths with a stratified matched sample of 2,283 external GC deaths that used the existing standard GC form. The percentage of GCs that were reclassified into valid causes was calculated. Analyses according to subgroup (age, type of external cause) and exploration of the reclassifications of deaths between different cause groups were conducted. Qualitative data on the feasibility of the form were recorded by form users. Results: Investigation using the new form reduced all external GCs by 93% (95% confidence interval [CI] -97%, -88%), while the existing form decreased GCs by 66% (95% CI -68%, -64%). The IDEC form was most effective for external-cause GCs not of undetermined intent. Deaths that remained GCs were mainly due to a lack of detailed information on the circumstances of death, primarily poisoning and unspecified vehicle accidents occurring in a residence or on a road without witnesses. The IDEC form was found to be satisfactorily feasible in general, with specific suggestions for further improvement determined. Conclusions: The new form was more effective than the current standard form in reducing GCs and improving the quality of external causes. Feedback from the fieldwork highlighted opportunities for further improvement of external cause data.

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Quality of cause-of-death data in Brazil: Garbage codes among registered deaths in 2000 and 2015

Cited by 38 publications

References 21 publications

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996–2016

Changes in the quality of cause-of-death statistics in Brazil: garbage codes among registered deaths in 1996-2016

Improving the quality of external cause of death data in Brazil: evaluation and validation of a new form to investigate garbage codes

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