Factors associated with errors in death certificate completion: A nationalstudy in Taiwan

To identify characteristics of certifying physicians and the deceased that are associated with errors in death certificate completion in Taiwan, we re trospectively reviewed 4123 systematically sampled death certificates issue d in 1994. Multivariate analyses were used to assess the associations of va rious characteristics of the certifying physicians and the deceased with fo ur types of error. Of the 4123 death certificates reviewed, 2525 (61%) were completed correctly. In 289 (7%), only the mechanism(s) of death was given (Major Error 1); in 146 (4%), multiple causal sequences were given in part I (Major Error 2); in 800 (19%), a single causal sequence was given but wa s not specific enough (Minor Error 1); and in 363 (19%), a single causal se quence was given but the order was incorrect (Minor Error 2). Multiple logi stic regression analyses revealed that the probability of error in death ce rtification increased as the age of the deceased increased, the age of the certifier decreased, and the level of the hospital decreased. These finding s suggest that training in death certificate completion should focus on you nger certifiers and those working at lower level teaching hospitals and non teaching hospitals. Given the high rate of Minor Error 1, physicians should be reminded to state information as specifically as possible to render cau se-of-death statistics more informative. (C) 2001 Elsevier Science Inc. All rights reserved.