title: Quality of cause-of-death reporting using ICD-10 drowning codes: a descriptive study of 69 countries.
abstract: BACKGROUND
  The systematic collection of high-quality mortality data is a prerequisite in designing relevant drowning prevention programmes. This descriptive study aimed to assess the quality (i.e., level of specificity) of cause-of-death reporting using ICD-10 drowning codes across 69 countries.
  
  
  METHODS
  World Health Organization (WHO) mortality data were extracted for analysis. The proportion of unintentional drowning deaths coded as unspecified at the 3-character level (ICD-10 code W74) and for which the place of occurrence was unspecified at the 4th character (.9) were calculated for each country as indicators of the quality of cause-of-death reporting.
  
  
  RESULTS
  In 32 of the 69 countries studied, the percentage of cases of unintentional drowning coded as unspecified at the 3-character level exceeded 50%, and in 19 countries, this percentage exceeded 80%; in contrast, the percentage was lower than 10% in only 10 countries. In 21 of the 56 countries that report 4-character codes, the percentage of unintentional drowning deaths for which the place of occurrence was unspecified at the 4th character exceeded 50%, and in 15 countries, exceeded 90%; in only 14 countries was this percentage lower than 10%.
  
  
  CONCLUSIONS
  Despite the introduction of more specific subcategories for drowning in the ICD-10, many countries were found to be failing to report sufficiently specific codes in drowning mortality data submitted to the WHO.
authors.affiliation: National Centre for Health Information Research and Training, School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Australia.
authors.forename: Tsung-Hsueh
authors.initials: TH
authors.lastname: Lu
authors.forename: Philippe
authors.initials: P
authors.lastname: Lunetta
authors.forename: Sue
authors.initials: S
authors.lastname: Walker
mesh_terms: D002423:Cause of Death; D059019:Clinical Coding / Q000592:standards*; D004332:Drowning / Q000145:classification* / Q000401:mortality*; D006801:Humans; D038801:International Classification of Diseases; D014944:World Health Organization