Audit of medical certificate of cause of death at a tertiary care teaching hospital

Abstract

Medical or medicolegal documentslike medical certificate of cause of death (MCCD) are importantin view of mortality statistics.Such certificates are inaccurately orincompletely filled then these have adverse impact on health and diseasesrelated statistics.We analysed 278 MCCDsformajor errors,minor errors and completeness ofinformation attertiary care teaching hospital, Navi Mumbai,India.Almost all certificate (100%) had either a major or minor error.We observed atleast one major error(244, 87.76%) and minor error(276, 99.28%)in MCCDs. The most common major error wassequencing errors(180, 64.74%), followed by unacceptable cause of death (105, 37.76%). Combination of two major errors was seen in 99 (35.61%) MCCDs and combination of two minor errors were seen in 143 (51.43%) MCCDs. Most common minor error was no mention of time interval (275, 98.92%). Incomplete MCCD was observed in 44 (15.82%) cases and maximum certificate had not commented or mentioned aboutstatus of pregnancy/delivery (n=24, 8.63%) in the certificates. In our study most common cause of death as per ICD classification was Circulatory (n=105, 37.76%). Similar studies should be regularly conducted to understand the burden of errorsmade by clinicians.Even routine audit ofMCCDswill help to assessthe problemin hospitals. We recommend routine educationalworkshoptotrainthe cliniciansregardingcomplete and accurate fillingof MCCDs.