Calidad en la certificación de mortalidad y natalidad en un hospital universitario en Colombia, 2014

This study aimed to describe and analyze the birth and death certification process in a medicine-teaching hospital in Bogotá during 2014, regarding both the information flow and the quality of the reported death cause. A methodology was designed to monitor the quality and coverage of the birth and death hospital statistics. Seventeen final-year medicine students attending to their public health training took part in the data collection about 511 clinical records of non-fetal deaths, and excluding the deaths due to external causes occurring in 2014, (it accounts for 58% of all non-fetal deaths in the hospital during this year). Being granted access to the medical records of the deceased patients, the duly instructed students completed the death certificate forms and were supervised by different specialist teachers according to the diagnosis. The basic death cause attributed after the supervision was compared to the death cause originally certified by the hospital physicians in the online record system currently used in Colombia: RUAF-ND. The agreement in identifying the basic death cause was estimated and a gross matching of 80% was found, with a Kappa index between 57% and 95%, being all statistically above zero after grouping the basic death causes as per CIE10 chapter, and obtaining 6% of unusable codes in both databases. This study could be replicated in other medicine-teaching hospital in order to strengthen the medical student training in vital statistics while monitoring the quality of the birth and death records in the medicine-teaching hospitals.