The study on the causes of death of people in Maejai district, Phayao province

Abstract

The study aimed to compare consistency of causes of death as specified in deathcertificate and causes of death as diagnosed by physicians. The target population was 250decedents of population in Maejai District, Phayao Province, who died during October 1,2000 – September 30, 2001, using death certificate as the major information. Thecollection of decedent’s information that had no treatment record was done by interviewof decedent’s relatives. The collection of those that had their treatment records at MaejaiHospital was done from the treatment profile. Then the physician diagnosed causes ofdeath of those decedents in ICD-10 code. Kappa coefficient analysis was used todetermine correlation.Results showed that only 58.4% of the 250 deaths were reported by a physician,And only 55.78% consistency between causes of death in the certificate and physiciandiagnosis, showing low agreement (r = 0.461, p < 0.01) The top three causes of deathaccording to death certificate and physician diagnosis was also different. Heart attack, thetop cause of death according to death certificate (37.76%), was not on the list of topcauses of death by physician diagnosis. According to physician diagnosis, AIDS, reportedwas the second cause of death (23.24%) by the certificate, was the top cause of death inPhayao during the study period, (37.60%). Hypertension that was not on the list of topcauses of death was found by physicians to be 4.8% of deaths in Phayao during the studyperiod.The study indicates inaccuracy of causes of death reported in death certificates inPhayao Province. Even if Phayao is a small province in northern Thailand, this findingshould not be much different from most of the provinces of the country. Reporting,accurate causes of death are fundamental to setting up appropriate health developmentpolicies, and allocation of scarce health budget, therefore, it must be improved.