Assessment of the accuracy of death certification at two referral hospitals.

Background: Death certification is a vital source of information used in mortality statistics worldwide to assess the health of the general population. This study focuses on the consistency of information between the death reports and the clinical records (files) of deceased patients in two hospitals: the King Khalid University Hospital (KKUH) and King Fahad National Guard hospital (KFNGH) in Saudi Arabia.

Methods: A random sample of the records of 157 deceased patients' registered in 2002 in the two hospitals was retrospectively reviewed independently to determine the underlying cause of death and compare them with death reports. It was also to check the accuracy of the translation from English in to Arabic.

Results: It was found that the underlying cause of death was misdiagnosed in 80.3% of the death reports. When the two hospitals were compared, no significant difference was observed (p>0.05). In addition, 81.8% of the accurate (correct) death reports in both hospitals were of patients who had died of a malignant disease. However, the translation of the underlying cause of death in KFNGH was correct in 86.1% of the death reports, while in KKUH it was only 25%, which is highly statistically significant (p<0.0001).

Conclusion: With the limitation of studying only a small number of cases, these results indicate a discrepancy between the file and death reports in relation to the cause of death. Also, the translation of the cause of death was inconsistent in the two hospitals. Hence, there is a real need to adopt suitable measures to improve the quality of death certification.