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Revista Española de Salud Pública

versão On-line ISSN 2173-9110versão impressa ISSN 1135-5727


CIRERA, Lluís et al. More than a decade of improvement in medical and judicial certification in the statistics of causes of death. Rev. Esp. Salud Publica [online]. 2018, vol.92, e201806031.  Epub 06-Jun-2018. ISSN 2173-9110.


After the return of democracy to Spain and the assumption of governmental powers by the regional areas, measures were taken to improve cause-of-death statistics. The objective of this study was to describe the evolution of the activities undertaken to improve the quality of mortality statistics in the region of Murcia from 1998 to 2011.


A descriptive epidemiological study of all the death documentation processed by the mortality registry in Murcia. Relative quality indicators were used to evaluate the fulfilment of documentation by doctors and court staff. This was backed up by information recovery regarding the causes and circumstances of death, and evaluating the impact on the mortality statistics of ill-defined, unspecific and less specific causes.


During the study-period, lack of temporal sequence on the medical death certificate reduced from an initial 46% to a final 21% (p<0.001). Retrieval of information from the various sources was successful in 93% of cases in 2001 compared with 38% at the start of the period (p<0.001). Regional rates of ill-defined and less specific causes have reduced more than the national Spanish rates, with a difference of 10.3 (p<0.001) and 2.8 points (p=0.001), respectively.


Medical certification of death has improved both form and suitability. The regulated recovery of the causes and circumstances of death corrected medical and judicial information. Murcia presented lower age-adjusted death rates of less specific and ill-defined causes than the national average.

Palavras-chave : Mortality statistics; Quality control; Death certificate; Cause of death; International Classification of Diseases; Health information systems; Medical informatics; Coroners and medical examiners; Spain.

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