Do doctors read forms? A one-year audit of medical certificates submitted to a crematorium

Abstract

To determine the thoroughness and accuracy with which medical certificates for cremation are completed, a record was made, during normal processing of the documents, of the number of questions that were not answered or answered wrongly, or in which clarification was required. Of 835 sets of forms only 346 (41 %) were completed sufficiently accurately for the cremation to proceed without further enquiry. Junior doctors contributed the most errors but general practitioners and consultants also contributed large numbers of errors. Doctors ought to be far more accurate and thorough in completing cremation certificates than were those audited here. The results cast doubt on the reliability of information supplied on other forms. In view of the high frequency of poorly completed forms, review by a medical referee remains essential.

A Study Of Cause of Death Certificates In India

“…This standard format is approved by the WHO and the Terminology of the Diseases /Lesion entered In the present study of the 690 certificates studied 258 certificates were from Hospital death records and 632 certificates were from Autopsy records. Of the 258 Hospital death certificates only 30.4% of the certificates were of minimum standards though adequate terminologies used to satisfy ICD10 coding few errors and omissions were present pertaining to Demography, Autopsy and Authors information this is in close observation to similar study conducted by Swift B, West K. [4] and Horner JS, Horner JW [5]. where 54% had minimal standards and 10% completed to a poor standard and only 41% had acceptable standards [5] which is in sharp contrast to the present study and that of wherein 69.6% certificates showed inappropriate or inadequate information.…”

“…Of the 258 Hospital death certificates only 30.4% of the certificates were of minimum standards though adequate terminologies used to satisfy ICD10 coding few errors and omissions were present pertaining to Demography, Autopsy and Authors information this is in close observation to similar study conducted by Swift B, West K. [4] and Horner JS, Horner JW [5]. where 54% had minimal standards and 10% completed to a poor standard and only 41% had acceptable standards [5] which is in sharp contrast to the present study and that of wherein 69.6% certificates showed inappropriate or inadequate information. Of the 632 Autopsy death records only 15% of the recordings were of minimum standards though adequate terminologies used to satisfy ICD10 coding few errors and omissions were present pertaining to Demography, Autopsy and Authors information this is in sharp contrast to observations made by Fernando R.…”

Detection of Medical Examiner Cases From Review of Cremation Requests

“…Not only will this alter vital statistics data but also changing the manner of death to accident could have financial benefits to the families with regard to various life insurance policies. As previous studies have demonstrated, the completion of death certificates is not always correct, even if tissue diagnosis are provided, [3][4][5][6][7] and is something that appears to be lacking in most medical school curriculum and residency teaching. 8,9 The investigators that communicate with the physicians feel that they do have some impact on teaching the physicians on how to recognize potential medical examiner cases (D.C.W., personal communication).…”

“…4 Higher numbers have been reported. McKelvie 5 reported major discrepancies between the death certificate and autopsy findings in 12% of 132 cases, and Horner and Horner 6 found that of 835 death certificates, only 346 (41%) were completed sufficiently for cremation to proceed without further investigation. Other issues with death certificates have included lack of information.…”

Mortality and cause of death in the Pacific

“…This is useful in reviewing the quality of the processes employed in completing the certificate and the plausibility of the results, but cannot give an indication of the consistency of the findings with the medical history of the deceased and is therefore limited in terms of being able to apply correction factors to the collected data. The second is a review of the certificate against the medical record for the deceased (265)(266)(267)(268)(269)(270)(271), in which a medical practitioner or team of practitioners reviews the case history and completes a "mock' medical certificate to be compared against the original. This approach relies on access to identifiable data, and assumes the reviewing physician or team is both independent and is more accurate than the original physician.…”