Errors in the completion of the death notification form
Objectives. To determine the frequency of errors in the cause of death sequence and to assess the completeness of information recorded on death notification forms (DNFs). Design. A population-based descriptive study. Setting. All residents of two residential areas in the Cape Town metropole who died during the period 1 June 2003 to 31 May 2004. Methods. We examined DNFs for pre-specified major and minor errors, assessed potential predictors of major errors using multivariate analysis, and assessed the DNFs for completeness in terms of particulars of the deceased, the informant and the health professional certifying death. Results. 844 DNFs were evaluated. Errors were found in 91.7% (95% CI 89.7 - 93.4%) of DNFs, and 43.4% (95% CI 40.1 - 46.7%) had at least one major error, most commonly an illogical cause of death sequence. Factors that seemed to affect the frequency of major errors were the number of lines of the cause of death sequence that had been completed, the age, gender and area of residence of the deceased, and the type of facility where the DNF had been completed. Varying levels of completeness were found for different items of information with some questions such as the education, occupation, usual business and smoking history of deceased being largely ignored by health professionals. Conclusion. An unacceptably high proportion of DNFs in the greater Cape Town area contain errors sufficiently serious to affect the accuracy of cause of death coding. This has far-reaching implications for the reliability of mortality data in South Africa. Educational, managerial and administrative interventions are urgently needed to improve the standard of DNF completion.