title: Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes.
abstract: OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes. METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes. RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights. CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore, the redistribution of the remaining ill-defined causes based on the investigation allows for more appropriate estimates of the mortality risk due to specific causes.
authors.affiliation: Faculdade de Medicina, Belo Horizonte, Belo Horizonte, MG, Brasil.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: França
authors.affiliation: Grupo de Pesquisa e Avaliação em Saúde, Faculdade de Medicina, Belo Horizonte, Belo Horizonte, MG, Brasil.
authors.forename: Renato
authors.initials: R
authors.lastname: Teixeira
authors.affiliation: Gerência de Epidemiologia e Informação, Belo Horizonte, Belo Horizonte, MG, Brasil.
authors.forename: Lenice
authors.initials: L
authors.lastname: Ishitani
authors.affiliation: Faculdade de Medicina, Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Bruce Bartholow
authors.initials: BB
authors.lastname: Duncan
authors.affiliation: Coordenação Geral de Informações e Análise Epidemiológica, Secretaria de Vigilância à Saúde, Ministério da Saúde, Brasília, DF, Brasil.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Cortez-Escalante
authors.affiliation: Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO, Brasil.
authors.forename: Otaliba Libânio de
authors.initials: OL
authors.lastname: Morais Neto
authors.affiliation: Centro de Informação Científica e Tecnológica, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
authors.forename: Célia Landman
authors.initials: CL
authors.lastname: Szwarcwald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods*; D003644:Death Certificates; D005260:Female; D006751:Hospital Information Systems; D006801:Humans; D007223:Infant; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D055815:Young Adult