Calidad del diligenciamiento del certificado de defunción en hospitales universitarios de Bogotá, Colombia

Objective Evaluate the quality of filling out the underlying cause of death on the death certificate. Methods Formative (prospective) and evaluative (retrospective) study. 288 medical records of non-fetal natural deaths that occurred in 2021 in three university hospitals in Bogotá were analyzed. The quality of filling out the underlying cause of death was evaluated in two ways: the frequency of use of useless codes and the agreement by ICD-10 chapters, between medicine students trained in filling out death certificates and physicians who registered the death in 2021. Results The use of useless codes as the underlying cause of death was higher among trained medicine students (14.2%) than among physicians (8.7%). 72.6% of these codes could have a high or very high negative impact on guiding public health policies. When grouping the basic causes of death by ICD-10 chapters and comparing between students and physicians, a gross matching of 84.7% and a kappa index of 0.76 (95% CI: 0.70-0.83) were obtained. Conclusions It is pertinent to strengthen the training of doctors in the correct filling out of death certificates and to routinely calculate quality indicators such as the frequency of use of useless codes and the kappa index, in order to obtain more accurate mortality statistics that support the evaluation and design of public policies in the country.