DEATH CERTIFICATION BY HOUSE OFFICERS AND GENERAL-PRACTITIONERS - PRACTICE AND PERFORMANCE

The objective of this study was to assess the knowledge, attitudes and behaviour of House Officers and General Practitioners (GPs) in relati on to death certification, to determine the scope for future intervent ion. A postal questionnaire was used to survey all House Officers (174 ) and a 10 per cent random sample of GPs (131) in Mersey Region. The m ain outcome measures were: death certification experience; knowledge, attitudes and behaviour in relation to data uses and coding; and accep tability of Cause of Death statements. Response rates were comparable- 119/174 House Officers (68.4 per cent) and 95/131 GPs (72.5 per cent). Most House Officers (78.8 per cent) and GPs (85.3 per cent) reported that they made the best possible Cause of Death statement but, respect ively, 62.4 per cent and 59.3 per cent of these might modify a stateme nt in some circumstances. Significantly more House Officers (70.3 per cent) than GPs (44.2 per cent) acknowledged room for improvement and w ere amenable to more training (86.6 per cent versus 52.5 per cent), bu t significantly fewer felt sufficiently instructed (23.7 per cent vers us 52.6 per cent). Most respondents (>90 per cent) considered accurate death certification important, but 46-2 per cent of House Officers ha d not read the death certificate book instructions. Knowledge was vari able, especially concerning Underlying Cause of Death. Written Cause o f Death statements were broadly similar in style and standard between groups. Experience did not appear to improve death certification pract ice. Better and co-ordinated undergraduate and early postgraduate educ ation (which should be continuing and audited), and practical accessib le guidance on death certificate completion, might improve standards o f practice and performance within the existing framework. Alternative methods of presenting guidance on death certificate completion should be explored.