Table 3.
Clinical parameters associated with death certificates completed by first-year general practitioners
| Clinical parameters | All general practitioners (n = 155) | Correct DC GP group (n = 47) | Incorrect DC GP group (n = 108) |
|---|---|---|---|
| 1. Overall DC knowledge, n (%) | 65 (41.9) | 21 (44.7) | 44 (40.7) |
| ▪ Understands that DCs are used in public health research and policy, n (%) | 66 (42.6) | 23 (48.9) | 43 (39.8) |
| ▪ Can differentiate between COD and MOD, n (%) | 39 (25.2) | 14 (29.8) | 25 (23.1) |
| 2. High level of self-confidence in identifying correct underlying COD, n (%) | 41 (26.5) | 15 (31.9) | 26 (24.1) |
| 3. Factors influencing errors in COD, n (%) | |||
| ▪ Lack of appropriate knowledge | 51 (32.9) | 15 (31.9) | 36 (33.3) |
| ▪ Extenuating circumstancea | 17 (11.0) | 3 (6.4) | 14 (13.0) |
| ▪ High workload | 33 (21.3) | 7 (14.9) | 26 (24.1) |
| ▪ Lack of adequate data | 28 (18.1) | 10 (21.3) | 18 (16.7) |
| ▪ Other/non applicable | 26 (16.7) | 12 (25.5) | 14 (12.9) |
| 4. Time spent on COD determination and DC completion in medical curriculum (hr), mean ± SD | 2.1 ± 0.9 | 2.2 ± 0.7 | 1.8 ± 0.9 |
| ▪ Time spent on COD and DCs < 2 h, n (%) | 96 (73.8) | 29 (74.4) | 67 (73.6) |
| 5. COD coding experience, n (%) | |||
| ▪ Have experience completing DCs by themselves during medical school | 43 (27.7) | 17 (36.2) | 26 (24.1) |
| ▪ Have experience completing DCs by themselves > 5 cases/month after graduation | 105 (67.7) | 33 (70.2) | 72 (66.7) |
| 6. Established COD coding training program in work hospital, n (%) | 45 (29.0) | 13 (27.7) | 32 (29.6) |
| 7. Person responsible for completion of death certificates during office hours, n (%) | |||
| ▪ Primarily senior physicians | 16 (10.4) | 5 (10.6) | 11 (10.3) |
| ▪ Primarily general practitioners | 126 (81.8) | 38 (80.9) | 88 (82.2) |
| ▪ On-duty general practitioner | 3 (2.0) | 0 (0) | 3 (2.8) |
| ▪ Other | 9 (5.8) | 4 (8.5) | 5 (4.7) |
| 8. Person responsible for completion of death certificates during after hours, n (%) | |||
| ▪ Primary senior physicians | 3 (2.0) | 1 (2.1) | 2 (1.9) |
| ▪ Primary general practitioners | 31 (20.1) | 16 (34.0) | 15 (14.0) |
| ▪ On-duty general practitioner | 112 (72.7) | 27 (57.5) | 85 (79.4) |
| ▪ Other | 8 (5.2) | 3 (6.4) | 5 (4.7) |
Categorical variable; number (percent), continuous normally-distributed variable; mean ± standard deviation. Significant differences across correct and incorrect DC GP group were identified for normally distributed continuous variables by t-test
Abbreviations: N Number, % Percent, COD Cause of death, MOD Mode of death, DC Death certificate, DCs Death certificates, SD Standard deviation, GP General practitioner
p-value < 0.05 indicates statistical significance; all parameters in this table were p above 0.05
aAn example of an extenuating circumstance would be a family member of the deceased that requests that you alter the COD in order to conceal the fact that the patient had HIV infection