Problems of assessment and analysis of mortality rates in the context of the rules of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10)

Abstract

Purpose of the study: to study changes in the structure of causes of death among those who died aged 18 years and older according to medical death certificates (MDC) and to discuss the problems of assessing the contribution of certain groups of diseases and conditions to the mortality of the population. Materials and methods. The source of information was the electronic database of the Main Directorate of the Civil Registry Office (USR registry office of the Moscow Region) of the MSS for those who died at the age of 18 and older for 2019, 2021 and 2022. one of the subjects of the Russian Federation. Results: All 3 years 99 % of deaths occur in 12 classes of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10); 3 classes (diseases of the circulatory system – DCS, nervous system – DNS and neoplasms) accounted for 70 % of deaths in 2019, 58 % in 2021 and 62 % in 2022 (the share decreased due to COVID-19). The share of DCS was 40 %, 32 % and 37.7 %; neoplasms – 15.3 % 10.9 % and 13.5 %. The greatest decrease in mortality was noted in the class of mental and behavioural disorders (MBD; 8 times: 58.4 in 2019 and 7.4 per 100 thousand in 2022). The proportion of male deaths over all 3 years was higher in the classes of injury and poisoning (IP), infectious diseases (ID), diseases of the respiratory system (DRS) and digestive system diseases (DDS). The highest age of the deceased was registered according to the classes of DNS and diseases of the genitourinary system (DGS); the youngest age in ID and IP classes. For all 3 years, more than 60 % of deaths in a hospital are registered in the classes of ID and DDS, and in 2021 and 2022 from COVID-19. Deaths at home predominate in the class of DNS and ill-defined conditions (class R). For individual codes in the classes of DCS, DNS, MBD, DGS, representing non-prohibited but unspecified causes of death, significant changes (hundreds and thousands of cases) were revealed in dynamics, which is probably due to a change in approaches to coding primary cause of death and affects the structure of mortality by classes and individual reasons. Conclusions. Significant annual changes in the number of deaths from individual causes, differences in demographic characteristics by ICD classes require clarification of the criteria for using individual 4-digit codes and subsequent analysis of mortality for clinically related groups of diseases.