Adjusting the German Cause-of-Death Statistics: Redistributing “Non-Informative” Icd-Codes

Annelene Wengler , Robert Koch-Institute

The German cause-of-death statistics are often utilized to draw conclusions about the health status of the population and the significance of certain diseases. Unfortunately cause-of-death statistics – not only in Germany – often include a relatively high proportion of “non-informative” ICD-codes. “Non-informative” means that an ICD-code does not sufficiently reflect the underlying cause of death. For example this may be the case when the indicated ICD-code is intermediate (e.g. heart failure) or non-specific (e.g. unspecified cancer). Using the most current data for Germany (2017) and the framework of the Institute for Health Metrics and Evaluation (IHME) in the Global Burden of Disease Study (GBD), the proportion of non-informative codes is 26.0 %. After identifying non-informative ICD-codes it is necessary to further process those codes. We do so by redistributing non-informative codes to valid ICD-codes. The method of redistribution and the resulting changes in the German cause-of-death statistics form the center of this paper. For some diseases (e.g. diabetes) we see that the number of deaths manifolds after the adjustment process. This has strong implications for drawing conclusions from cause-of-death statistics and hence for public health research in general. The cause of death can be seen as the final health outcome of a person. Knowing precisely what people die off and in what number is of great importance when analyzing the health of a society.

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 Presented in Session P2. Poster Session Ageing, Health and Mortality