ABSTRACT
【Objective】 To evaluate the underreporting of death cases and related factors in disease surveillance system of Xi’an. 【Methods】 Multi-stage cluster random sampling was used, and 733 villages (neighborhood committees) were selected from 44 townships or streets in Xi’an. All the death cases of the residents in the sampled areas from 2018 to 2020 were collected through a variety of channels and checked with those registered in the Disease Surveillance System. Then the missing cases were investigated and verified. The underreporting rate was calculated, the Excel software was applied for statistical processing and Chi square analysis, and the related factors of underreporting were analyzed by using Logistic regression method. 【Results】 A total of 37650 death cases were investigated from 2018 to 2020; the average mortality was 650.59/105, and 2 901 cases were underreported. From 2018 to 2020, the underreporting rate was 9.89%, 6.95%, and 6.24%, respectively (χ2=133.525, P<0.001), with the average underreporting rate of 7.71%. The underreporting rate in the 44 sampled areas ranged from 0.90% to 42.07%. Multivariate Logistic regression analysis showed that compared with that in rural areas (9.87%), the underreporting rate was lower in urban areas (5.91%, OR=0.567, 95% CI:0.525-0.613), and higher in children under 5 years old (31.20%, OR=5.494, 95% CI:3.732-8.090) and people aged 15-44 years old (11.85%, OR=1.541, 95% CI:1.284-1.846) compared to people over 65 years old (7.44%), and higher in 2018 (9.89%, OR=1.702, 95% CI:1.551-1.869) and 2019 (6.95%, OR=1.148, 95% CI:1.038-1.271) compared to the year 2020 (6.24%). There were 2901 cases reported missing, and the proportion of those who died at home was the highest (81.39%). Underreporting of death more easily occurred in heart diseases (36.80%) and cerebrovascular diseases (27.08%) than others. 【Conclusion】 The reporting completeness of disease surveillance system increased in Xi’an. The overall underreporting rate of death causes decreased with year from 2018 to 2020. The underreporting rates in age group under 5 years old and in rural population were still high. Therefore, the reporting and management of death information should still be strengthened to minimize the underreporting rate.
ABSTRACT
Objective@#To understand the underreporting rate of death among residents in Zhejiang Province from 2016 to 2018, so as to provide a basis for improvement of death surveillance measures. @*Methods@#Multi-stage random cluster sampling was used to select residents in 30 public health surveillance areas of Zhejiang Province and all the residents were investigated the general information and death conditions that occurred during the period 2016-2018 by door to door visit. The underreporting rate of death was calculated and descriptive methods were used to analyze the causes of underreporting deaths.@*Results@#A total of 358 992 residents were investigated in 30 public health surveillance areas of Zhejiang Province. There were 63 underreporting deaths among 5 896 deaths, with an underreporting rate of 1.07%. The underreporting rate in men was 1.30%, which was higher than 0.75% in women ( P<0.05 ). The underreporting rate of residents aged 20 to <40 years was 6.74%, the highest among all the age groups ( P<0.05 ). The underreporting rate was 4.46% on the way to the hospital, the highest among all the places of death ( P<0.05 ). The underreporting rate in Wuxing District of Huzhou was 5.80%, the highest among all the surveillance areas. There were 25 cases of "late report or untimely review", accounting for 39.68%; 38 cases of "not report", accounting for 60.32%, of which 14 cases were caused by doctors forgetting to report, accounting for 22.22%. @*Conclusion@#The underreporting rate of death in Zhejiang Province from 2016 to 2018 is generally low. In response to underreporting deaths, multi-departmental collaboration should be promoted to effectively strengthen the reporting and management of routine death surveillance.