The national mortality information system: problems and proposals for solving them II - Deaths due to external causes

Given that the importance of morbidity and mortality due to accidents and violence is increasing in Brazil and that, coroners frequently do not fill out the death certificate (DC) with the external cause which prompted the lesion that led to death, a decision was made to analyze all these deaths, even cases in which the information in the original DC could be considered appropriate. The aim of this research was to verify the level and amount of proper information put into the DC and up to what extent the ones labeled as inadequate could be enhanced; it also aimed to verify the gains provided by using a very simple method for recovering information. There were 320 deaths due to external causes, in the last quarter of 2000, in 15 Brazilian municipalities with heterogeneous demographic, social and economic characteristics, in the states of Sergipe, São Paulo, Mato Grosso. The clarification of each situation was obtained through consultation to autopsy reports in Forensic Institutes, reports at police stations and, whenever necessary, home visits. The results showed important changes in these causes of death. The numbers of deaths due to homicides, suicides and transportation accidents grew, respectively, six fold, two-fold and 90% after the investigation in relation to the original DC; and there was a significant decrease in deaths due to unknown external causes. Although deaths due to external causes are known to be better informed than deaths due to natural causes, there is much to be done in order to solve the problem of ill-defined causes. The adoption of this very simple and accessible methodology can lead to the desired improvement in these data.

Mortality; External causes; Quality of information

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