Regional experience in the management of mortality monitoring

Abstract

The article describes the module “Medical certificate of death” of the medical information system of the Orenburg region. The article describes the results of operational monitoring of mortality in the Orenburg region. The purpose is to analyze the results of monitoring mortality from all causes in the Orenburg region. Materials and methods. A comprehensive analysis of the deaths registered in the Orenburg region in 2019 and 2020 was made. For this purpose, the depersonalized database of medical death certificates of the mortality monitoring system of the MIAC of the Orenburg region was used. The results were evaluated using parametric and nonparametric methods. Results and discussions. The absolute number of deaths increased by 26% in 2020 compared to 2019. The maximum increase in mortality occurred in the class of “Respiratory diseases”. The leader in the absolute number of deaths with an increase of 40.5% was “Diseases of the circulatory system”. In general, the database does not trace the existence of a logical chain between the initial and immediate causes of death. In 78.67% of all causes of death according to medical certificates, the class of the original cause is not established. Limitations. The research materials are limited by the capabilities and completeness of the database of medical death certificates of the MIAC mortality monitoring system. Conclusions. The main part of the indicators in the structure due to the initial cause of death is associated with unspecified and unassigned conditions. A large proportion of causes of death where the class is not established are due to non-compliance with the ICD-10 coding rules for coding causes of death and choosing the original cause of death. There is no clear expert system of immediate and initial causes of death.