title: [Female mortality in the Municipality of São Paulo: quality of medical death certificates].
abstract: OBJECTIVE
  To evaluate the quality of the medical certification of deaths of 10-49 year-old women, resident in the Southern region of the city of S. Paulo
  
  
  METHODS
  The Puffer methodology was utilized to investigate the causes of death of all 10-49 year-old women, resident in the region, and deceased in the year 1989 (664 deaths in the total). The main causes of death in the original death certificates and the "new" causes of death arisen from the research were compared. The sensitivity and the kappa index were calculated.
  
  
  RESULTS
  In some chapters of the International Classification of Diseases and Causes of Death, 9th Revision (CID-9), a high sensitivity was found: "Diseases of the Circulatory System" (91.9%), "Neoplasms" (89.7%) and "External Causes" (84.1 %). In some others, a very low sensitivity was found. The chapter "Mental Illnesses", with a 34.3 percent sensitivity only, must be mentioned. From 11 deaths originally classified in this chapter, 32 cases were found. In most of these "new" cases, the main cause of death was found to be alcoholism. The chapter "Complications of Pregnancy, Delivery and the Puerperium", also showed a low sensitivity (44.9%). The kappa index was found to be 0.63, which indicated a regular concordance.
  
  
  CONCLUSIONS
  The quality of the medical certification of causes of death is still unsatisfactory in the studied area. This poor quality may affect negatively the interventions in the area of women's health, masking the severity of important problems
authors.affiliation: Departamento de Saúde Materno-Infantil da Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil. aafsique@usp.br
authors.forename: A A
authors.initials: AA
authors.lastname: Siqueira
authors.forename: E M
authors.initials: EM
authors.lastname: Rio
authors.forename: A C
authors.initials: AC
authors.lastname: Tanaka
authors.forename: N
authors.initials: N
authors.lastname: Schor
authors.forename: A T
authors.initials: AT
authors.lastname: Alvarenga
authors.forename: L C
authors.initials: LC
authors.lastname: Almeida
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D002648:Child; D003644:Death Certificates; D005260:Female; D006801:Humans; D008875:Middle Aged
vernacular_title: Mortalidade feminina na região Sul do Município de São Paulo: qualidade da certificação médica dos óbitos.