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Using death certificate data to study place of death in 9 European countries: opportunities and weaknesses

Cohen, Joachim; Bilsen, Johan; Miccinesi, Guido; Löfmark, Rurik; Addington-Hall, Julia; Kaasa, Stein; Norup, Michael; van der Wal, Gerrit; Deliens, Luc
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/300433
Date
2007
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  • Institutt for klinisk og molekylær medisin [2069]
  • Publikasjoner fra CRIStin - NTNU [20888]
Original version
BMC Public Health 2007, 7(283)   10.1186/1471-2458-7-283
Abstract
Background: Systematic and reliable epidemiological information at population level, preferably

cross-national, is needed for an adequate planning of (end-of-life) health care policies, e.g.

concerning place of death, but is currently lacking. This study illustrates opportunities and

weaknesses of death certificate data to provide such information on place of death and associated

factors in nine European countries (seven entire countries and five regions).

Methods: We investigated the possibility and modality of all partners in this international

comparative study (BE, DK, IT, NL, NO, SE, UK) to negotiate a dataset containing all deaths of one

year with their national/regional administration of mortality statistics, and analysed the availability

of information about place of death as well as a number of clinical, socio-demographic, residential

and healthcare system factors.

Results: All countries negotiated a dataset, but rules, procedures, and cost price to get the data

varied strongly between countries. In total, about 1.1 million deaths were included. For four of the

nine countries not all desired categories for place of death were available. Most desired clinical and

socio-demographic information was available, be it sometimes via linkages with other population

databases. Healthcare system factors could be made available by linking existing healthcare statistics

to the residence of the deceased.

Conclusion: Death certificate data provide information on place of death and on possibly

associated factors and confounders in all studied countries. Hence, death certificate data provide a

unique opportunity for cross-national studying and monitoring of place of death. However,

modifications of certain aspects of death certificate registration and rules of data-protection are

perhaps required to make international monitoring of place of death more feasible and accurate.
Publisher
BioMed Central
Journal
BMC Public Health

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