• 한국의료질향상학회지
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• 제11권1호
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• pp.4-14
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• 2004

Background : To examine the problems involved in writing practice of death certificates, we compared the determination of underlying cause of death for vital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 mortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record specialists. And causes of death determined at ministry of statistics for national vital statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificates were analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. And the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions that caused death too. Conclusion : When we examined the correctness of death certificate writing practice using above methods, correctness of writing could not be told as satisfactory. There was difference in correctness of writing between hospitals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

• 대한응급의학회지
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• 제29권5호
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• pp.529-550
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• 2018

Objective: This study investigated the most common errors on death certificates written by resident trainees of the emergency department and evaluated the effects of education on how to write a death certificate. Methods: A casebook of 31 deaths was prepared based on actual death cases in the emergency room in 2016. Ten residents completed 31 death certificates for the death casebook without any prior notice and then received education on 'How to write the death certificate.' They completed the death certificates again for the same casebook after receiving the education and the number of errors on all death certificates was again determined and divided into major and minor errors. The average number of error types was compared before and after the education. Results: Major errors occurred in 55% of all death certificates, but decreased to 32% after education. Minor errors decreased from 81% before education to 54% after education. The most common major error was 'unacceptable cause of death' (mean${\pm}$standard deviation [SD], $10.2{\pm}8.2$), and the most common minor error was 'absence of time interval' (mean${\pm}$SD, $24.0{\pm}7.7$), followed by 'absence of other significant conditions' (mean${\pm}$SD, $14.6{\pm}6.1$) before education. Conclusion: Education on 'how to write a death certificate' can help reduce errors on death certificates and improve the quality of death certificates.

• Journal of Preventive Medicine and Public Health
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• 제37권4호
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• pp.345-352
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• 2004

Objectives : Previous studies showed that death certification by physicians was an important predictor to improve the quality of death certificate data in South Korea. This study was conducted to examine the proportion of death certificates issued by physicians and associated factors in South Korea from 1990 to 2002. Methods : Data from 3,110,883 death certificates issued between 1990 and 2002, available to the public from the National Statistical Office of Korea, were used to calculate the proportion of death certificates issued by physicians and to examine associated factors with logistic regression analysis. Results : The overall proportion of death certificates issued by physicians increased from 44.6% in 1990 to 77.6% in 2002 (mean: 63.5%). However, the proportion was greatly influenced by the deceased's age. In 2002, more than 90% of the deceased aged 51 or less were certified by physicians. A higher proportion was found among deceased who had tertiary education (college or higher) living in more developed urban areas. Conclusion : The information regarding the cause of death for younger, well-educated deceased in urban areas of South Korea may show a higher level of accuracy. Epidemiologic research using information on causes of death may well benefit from the continually increasing proportion of death certificates issued by physicians in the future in South Korea.

• 대한수사과학회지
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• 제3권1호
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• pp.43-49
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• 2008

사망진단서의 상당수가 부적절하게 기록되고 있다. 이의 원인으로는 사망진단서 작성에 관한 교육의 부족과 사망진단서 작성자의 무관심 등에서 비롯된 것으로 보인다. 사망진단서 오류는 우리나라의 사망 환자 통계의 신빙성을 떨어뜨리고, 보건 정책 등에 올바르게 반영되지 못하는 결과를 가져오게 된다. 2005년 1월 1일부터 12월 31일까지 1년간 대구 소재 A병원에서 발급된 사망진단서 298건을 연구 대상으로 사망진단서의 오류를 조사하였다. 주오류중 사망기전만 기입한 경우 26건(8.7%), 경쟁 원인 기입은 28건(9.4%), 부적절한 진단은 34건(11.4%)이었다. 1개 이상의 주오류를 가진 경우는 88건(29.5%)이었다. 부오류는 시간 간격을 기입하지 않은 경우가 296건(99.3%), 직접사인과 선행사인은 기록하고 중간선행사인을 제외하였거나 직접, 중간선행, 선행사인에 같은 진단을 기입한 경우는 58건(19.5%), 한 칸에 2개 이상의 진단을 기입한 이중진단인 경우가 56건(18.8%) 등이었다. 오류가 없는 사망진단서는 88건으로, 전체 진단서 298건 중 29.5%밖에 되지 않았다. 사망진단서 작성의 정확성을 기하기 위하여 올바른 교육 프로그램 마련 및 교육의 강화가 절실히 요구된다.

• Journal of Preventive Medicine and Public Health
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• 제14권1호
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• pp.39-42
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• 1981

Recent changes in the cause of death among the Korean population seem to be systematic and significant. Data on cause of death from the medically certified death certificates provide at least four types of evidence: a sudden increase in recent years in the numbers of death due to cerebrovascular disease or circulatory diseases including rheumatic fever and chronic heart diseases and atherosclerosis; increasing steadily in the numbers of death due to malignant neoplasm of various sites, and death due to accident; decreasing steadily in the numbers of death due to communicable diseases or parasite diseases; and a large number of deaths with unspecified symptoms and ill-defined conditions. The lack of complete registration of the deads occurred or the incomplete description on the cause of death reported suggests that statistical information of cause of death from the medically certified death records is meaningful in interpreting changing patterns.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3617-3619
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• 2012

Background: The completeness of cancer registration is a major validity index of any reported cancer incidence. The present study aimed to evaluate the esophageal cancer incidence registered in the Tehran Metropolitan Area Cancer Registry. Materials and methods: The data on esophageal cancer abstracted from three sources of 1) pathology departments, 2) medical records, and 3) death certificates during 2003 till 2007 were utilized. The completeness of the data sources were evaluated using coverage (defined as the proportion of a community population with esophageal cancer identified by the source) and density (defined as the proportion of non-empty fields of the data by source). Results: A total 1,404 cases of esophageal cancer were reported for the duration of the study. Pathology provided 771, medical records 432, and death certificates 609. The coverage was 0.55 for pathology, 0.31 for medical records, and 0.43 for death certificates. The respective density values were 0.82, 0.96 and 0.98, respectively. Pathology (0.45) was the most complete source followed by medical records (0.42), and death certificates (0.29). Discussion: A low degree of completeness dictates putting more effort into case finding plus abstracting data more thoroughly.

• 의료법학
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• 제10권2호
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• pp.115-150
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• 2009

The Article 17 (1) of the Medical Service Act states that no one but medical doctor, dentist or herb doctor shall prepare medical certificate, post-mortem examination, certificate or prescription. Though medical certificate, post-mortem examination or certificate is a private document issued by doctor personally, it is accepted as reliable as public document. Therefore, for medical certificate, post-mortem examination or certificate, unlike other private document to guarantee authenticipy of the content, the Article 233 of the Criminal Act states the Crime of Issuance of Falsified Medical Certificates. In other words, the Criminal Act Article 233 states that If a medical or herb doctor, dentist or midwife prepares false medical certificate, post-mortem examination or certificate life or death, one shall be punished by imprisonment or imprisonment without prison labor for not more than three years, suspension of qualifications for not more than seven years, or a fine not exceeding thirtht million won. The subject of the Crime of Issuance of Falsified Medical Certificates is only a medical or herb doctor, dentist or midwife and the eligibility requirements are specified in the Medical Service Act. Medical certificate is the medical document to be issued by medical doctor to certify the health status and show the Jugdement about the result of the diagnosis, Post-mortem examination is the document to be listed by medical doctor to confirm medically about human body or dead body, and Certificate life or death is a kind of medical certificate to verify the fact of birth or death, the cause of death, such as Birth Certificate, Certificate of Stillbirth or Certificate of Dead Fetus. To constitute the crime of Issuance of Falsified Medical Certificates, it is necessary for the contents of the certificate to be substantially contrary to the truth, as well as it is needed the subjective perception that the contents of the certificate are false. The Supreme Court Decision 2004DO3360 Delivered on March 23, 2006 declared that although the Defendant did not MRI scan, etc. for precise observation about the disability status of Mr Park, it was difficult to believe that the contents of the Disability Certificate of this case were contrary to the objective truth or the defendant had perception that the contents of the certificate were false. I don't agree with the Supreme Court Decision, because the Supreme Court confirmed the decision by the court below despite the Supreme Court should have made the court below retry the reason why the Defendant did not MRI scan, etc. for precise observation about the disability status of Mr Park.

• 농촌의학ㆍ지역보건
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• 제35권1호
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• pp.89-98
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• 2010

의과대학 본과 4학년 학생들의 사망진단서의 작성 능력을 살펴보고자, 2007년 5월부터 8월까지 충청도, 전라도, 경상도의 4개 의과대학 본과 4학년 학생 380명을 대상으로 설문조사를 실시하였다. 설문지는 사망진단서 작성을 위한 10개의 사례들과 사망진단서 작성 양식, 그리고 사망진단서 작성과 관련된 교육 경험에 관한 문항들로 구성되었다. 교육 유형별 사망진단서 작성 정확도를 평가하기 위해 학생들이 기술한 사인들이 기준사인과 일치되는 정도와 기재내용의 오류 등을 파악하였다. 설문 미응답자 61명을 제외한 232명의 분석결과는 다음과 같다. 10개 사례에 대한 4단계 사망원인 평균 일치 개수 즉 CD는 $9.6{\pm}3.8$이었다. 4단계 사망원인들 중 최하단에 기재한 원사인의 평균 일치 개수 즉 UC1은 $4.8{\pm}1.7$이었고, 학생들이 기술한 4단계 사망원인들 중에서 사인분류사에 의해 선정 된 원사인의 평균 일치 개수 즉 UC2는 $5.6{\pm}1.5$이었다. UC1과 UC2는 사례중심 교육집단이 이론교육집단 보다 높았다. 주오류의 세부 내용별로 살펴보면 '선행사인 미기입'의 오류를 가진 경우(78.9%)가 가장 많았으며, 다음으로 '한 칸에 두개 사인 기입'(48.3%), 'II부에 I부 기입'(43.1%) 등의 오류를 범하는 경우 등이 많았다. 주오류와 부오류 모두 사례중심교육집단이 이론교육집단보다 평균 오류의 수가 더 적었다. 결론적으로 의과대학 본과 4학년 학생들의 사망진단서 작성능력은 사망진단서 작성 방법에 대한 교육 유형에 따라서 차이가 있으며, 사망원인통계의 정확성 향상을 위해서는 사망원인작성에 대한 교육이 이론 위주보다는 다양한 사례를 경험할 수 있도록 구성될 필요가 있다.

• 대한임상독성학회지
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• 제18권1호
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• pp.11-17
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• 2020

Purpose: This study examines errors in death certificates (DCs) issued to cases of poisoning. Methods: DCs issued in poisoning cases were retrospectively reviewed. Errors in the DC were classified as major and minor errors, and were evaluated in accordance with their impact on the process of selecting the cause of death (COD). Results: A total of 79 DCs were evaluated; 43 (54.4%) DCs were issued in the emergency department (ED), and 36 (45.6%) DCs were issued outside the ED. The average major and minor errors per DC were determined to be 0.4 and 3.3, respectively. Moreover, an average of 3.0 errors were discovered in DCs issued at the ED, and 4.4 errors in DCs issued outside the ED. The most common major errors were incorrect manner of death (11.4%, 9/79), followed by unacceptable COD (7.6%, 6/79), and the mode of dying as an underlying COD (5.1%, 4/79). The common minor errors most frequently encountered were incorrect time interval (86.1%, 68/79), followed by incorrect other significant conditions (73.4%, 58/79), and no record for date of onset (62.0%, 49/79). Conclusion: Our results indicate that the total numbers of major errors, minor errors and cases of misjudged cause of death were greater in DCs issued outside the ED than in DCs issued at the ED. The most frequently quoted major error of DCs related to poisoning was determined to be the incorrect manner of death.

• 농촌의학ㆍ지역보건
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• 제23권2호
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• pp.215-227
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• 1998

To find health problems of Pohang city and to plan the activities to solve them in the situation of localization, the mortalities of the citizens in recent three years from 1994 to 1996 were analyzed from the notices and the certificates of death. The ratios of the notices with the certificates of death In the rural area of Pohang city were higher than those of whole country, the ratios of the urban area were lower than the respective ones, and the ratio differences between the rural and urban area were increasing. It may be that medical facilities are not within easy access of the rural inhabitants. especially in the rural south district with high population density. The proportional mortality indicators(PMI) were lower them those of whole country, much lower in male. So the health status of young aged males is relatively unsatisfactory. The urban inhabitants died in hospitals about two times more than the rural inhabitants and the differences were increasing. It may be that living and housing conditions and socio-cultural differences affected on the places of death. Because it is thought that death in hospitals will be growing at high speed, it is necessary to enlarge facilities fur funeral services. The age standardized mortalities were lower than those of whole country and age grouped mortalities were also the same. There were not any consistent and meaningful findings in the sex ratios of mortality according to the age groups or the calendar years. The mortalities by neoplasms and cardiovascular diseases according to the twenty one major causes of death were rapidly increased from the middle ages in both male and female. So it is important to plan the activities for early detection and health maintenance or promotion by behavior modifications. The leading causes of death were cardiovascular diseases, hypertensive diseases, and traffic accidents. And accidental drowning because of coastal area, liver diseases in male, and low respiratory tract diseases in female were the leading causes of death in part of age groups.