Analysis of the filling of death certificates in Catanduva, São Paulo, Brazil

Abstract The death certificate is the main document for the Mortality Information System of the Brazilian Ministry of Health, covering quantitative and qualitative aspects of ethical, legal and epidemiological nature. The records of the Ministry present inconsistencies caused by many factors, especially those related to poor academic training and access to guidelines published by entities. This study sought to identify the main errors in filling death certificates registered in a teaching hospital in Catanduva, São Paulo, Brazil, from 2014 to 2017. Of the 805 certificates, 167 (20.7%) were incomplete, 59 (7.3%) had inadequate terms, 42 (5.2%) acronyms and abbreviations, 27 (3.3%) illegible handwriting, and 2 (0.2%) erasures. Despite the low frequency of errors, the analysis found deficits in knowledge and/or neglect of medical ethics, which compromise the quality of public health records.

摘要：死亡证明书（death certificate）是巴西卫生部（Brazilian Ministry of Health）死亡信息系统（Mortality Information System）的核心文件，涵盖伦理、法律与流行病学相关的定量与定性维度信息。卫生部的登记记录存在诸多不一致性问题，其诱因多样，尤以学术培训不足、对相关机构发布的指南知晓不足最为突出。本研究旨在识别2014至2017年间，巴西圣保罗州卡坦杜瓦市一家教学医院登记的死亡证明书填写过程中存在的主要错误。在805份死亡证明书中，167份（20.7%）存在填写不完整问题，59份（7.3%）术语使用不当，42份（5.2%）存在缩略词与缩写使用不规范问题，27份（3.3%）字迹难以辨认，另有2份（0.2%）存在涂改痕迹。尽管整体错误发生率较低，但分析仍发现存在医学知识储备不足和/或漠视医学伦理的情况，此类问题会损害公共卫生记录的质量。