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Open Access 01-12-2024 | Research

Territorial gaps on quality of causes of death statistics over the last forty years in Spain

Authors: Lluís Cirera, Rafael-María Bañón, Sergio Maeso, Puri Molina, Mónica Ballesta, María-Dolores Chirlaque, Diego Salmerón, Mortality Working Group of the Spanish Association of Epidemiology

Published in: BMC Public Health | Issue 1/2024

Abstract

Background

The quality of the statistics on causes of death (CoD) does not present consolidated indicators in literature further than the coding group of ill-defined conditions of the International Classification of Diseases. Our objective was to assess the territorial quality of CoD by reliability of the official mortality statistics in Spain over the years 1980–2019.

Methods

A descriptive epidemiological design of four decades (1980-, 1990-, 2000-, and 2010–2019) by region (18) and sex was implemented. The CoD cases, age-adjusted rates and ratios (to all-cause) were assigned by reliability to unspecific and ill-defined quality categories. The regional mortality rates were contrasted to the Spanish median by decade and sex by the Comparative Mortality Ratio (CMR) in a Bayesian perspective. Statistical significance was considered when the CMR did not contain the value 1 in the 95% credible intervals.

Results

Unspecific, ill-defined, and all-cause rates by region and sex decreased over 1980–2019, although they scored higher in men than in women. The ratio of ill-defined CoD decreased in both sexes over these decades, but was still prominent in 4 regions. CMR of ill-defined CoD in both sexes exceeded the Spanish median in 3 regions in all decades. In the last decade, women’s CMR significantly exceeded in 5 regions for ill-defined and in 6 regions for unspecific CoD, while men’s CMR exceeded in 4 and 2 of the 18 regions, respectively on quality categories.

Conclusions

The quality of mortality statistics of causes of death has increased over the 40 years in Spain in both sexes. Quality gaps still remain mostly in Southern regions. Authorities involved might consider to take action and upgrading regional and national death statistics, and developing a systematic medical post-grade training on death certification.

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Title: Territorial gaps on quality of causes of death statistics over the last forty years in Spain
Authors: Lluís Cirera
Rafael-María Bañón
Sergio Maeso
Puri Molina
Mónica Ballesta
María-Dolores Chirlaque
Diego Salmerón
Mortality Working Group of the Spanish Association of Epidemiology
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-023-17616-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Territorial gaps on quality of causes of death statistics over the last forty years in Spain

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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