A cross-sectional study on the knowledge and practice of medical certification of cause of death among junior doctors in a tertiary hospital in North-East India

Abstract

Background: Medical certification of cause of death (MCCD) is the formal document in which the doctor records the time, causes and circumstances of death of an individual. Inaccuracies and incomplete MCCD will lead to biased estimation of several epidemiological parameters. Hence this study was done to determine the knowledge and practice of MCCD among junior doctors and assess the association between knowledge and some selected variables of interest.Methods: A cross-sectional study was conducted among junior doctors constituting of interns, junior residents and post-graduates trainees of a tertiary hospital of Manipur from February to March 2020. A semi-structured, self-administered questionnaire was used. Data was entered in MS Excel and exported to SPSS version 21 where analysis was done. Descriptive statistics and Chi-square test was used for analysis and p<0.05 was taken as significant. Ethical clearance was obtained from the Institutional ethics committee.Results: Out of the 334 total respondents females constituted 53%. Only 88(26.3%) had satisfactory knowledge, and only 14% (47) of the respondents had ever issued MCCD.No significant association was seen between knowledge score and current department of posting, current designation, gender, religion and work experience.Conclusions: Only a quarter of the respondents (26.3%) were having satisfactory knowledge. There is a need to organize frequent workshops, seminars and induction training highlighting the importance of MCCD for the junior doctors with regular audits.

Evaluation of Medical Certification of Cause of Death in Tertiary Cancer Hospitals in Northern India

“…However, errors in death certificates are not limited to developing countries; for e.g., more than 50% of general practitioners in the United Kingdom and United States of America reported being insufficiently instructed about the process of death certification (Haque et al, 2013). While it is difficult to compare our findings with previous Indian studies due to differences in definitions and interpretations of errors, there are consistent findings among many previous studies, including our study, where the majority of MCCDs had a wrong cause of death that qualified as a major error (Bishwalata et al, 2020; Ganasva et al, 2016; Ganasva et al, 2015; Ghanshyam et al, 2018; Patel et al, 2017; Patil et al, 2019; Pokale et al, 2016; Uplap et al, 2019). Thus, evaluation of death certification through audits should become an essential practice and be conducted regularly in all hospitals, especially in lower-middle and lower-income countries where the quality and availability of death registration is poor, despite higher mortality burden as reported by the WHO (Mathers et al, 2017).…”

“…However, there is consistent nding among most of the previous studies, including ours, that the majority of the MCCDs have wrong cause of death certi cation, which qualify as major errors. [16][17][18][19][20][21][22][23] The current study included death certi cation for only cancer related deaths. Hence, our ndings may not be generalizable to other establishments.…”