TITLE:
The Effect of Coding Method on Cause-of-Death Rankings
AUTHORS:
Peter Harteloh
KEYWORDS:
Cause-of-Death Statistics, Cause of Death, Ranking, Automated Coding, Manual Coding, Epidemiology, Health Policy
JOURNAL NAME:
Open Journal of Statistics,
Vol.13 No.6,
December
6,
2023
ABSTRACT: Background: Cause-of-death rankings are often used for planning or evaluating health
policy measures. In the European Union, some countries produce cause-of-death
statistics by a manual coding of death certificates, while other countries use
an automated coding system. The outcome of these two different methods in terms
of the selected underlying cause of death for statistics may vary considerably.
Therefore, this study explores the effect of coding method on the ranking of
countries by major causes of death. Method: Age and sex standardized
rates were extracted for 33 European (related) countries from the
cause-of-death registry of the European Statistical Office (Eurostat).
Wilcoxon’s rank sum test was applied to the ranking of countries by major
causes of death. Results: Statistically significant differences due to
coding method were identified for dementia, stroke and pneumonia. These
differences could be explained by a different selection of dementia or
pneumonia as underlying cause of death and by a different certification
practice for stroke. Conclusion: Coding method should be taken into
account when constructing or interpreting rankings of countries by cause of
death.