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Electronic Death Certificates to Improve Accuracy of COVID-19 Mortality Figures

06 Apr 2020 | By Inserm (Newsroom) | Public health

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In order to obtain accurate mortality figures on the COVID-19 pandemic, the data provided by the various entities authorized to issue death certificates – health care establishments, community doctors, emergency medical service (SAMU), and care homes for the elderly – need to be collected quickly. Although it is possible to declare deaths electronically in France, this channel is underutilized despite the considerable time-saving it represents for data processing on a national scale. The widespread deployment of electronic death certification made possible by Inserm through its CertDc application should enable rapid acquisition of the figures needed, in order to improve monitoring of the pandemic.

In the war against the COVID-19 pandemic, unprecedented in its scale, reliable indicators are needed more than ever in order to monitor numbers of diagnosed cases and deaths. These are the figures that provide the public authorities, doctors and researchers with an overview of the situation and orient their decisions. High quality mortality data is also essential for epidemiological studies. Since 1968, Inserm has been tasked with producing statistics on the medical causes of death in France.

Every day, the country’s Health Directorate publishes the latest data at its disposal, with the mortality indicators communicated to the public having been collected primarily through the hospital system and health care establishments. The number of severe cases admitted to hospital intensive care departments is also shared in order to give a more comprehensive picture. Then there is the Public Health Agency, which measures the impact of the epidemic on both the health care system and mortality. It uses various sources, including the electronic death certificates that give a better idea of the characteristics of those who have died from COVID-19.

To further improve the reliability of the figures to reflect as closely as possible the national mortality rate associated with the COVID-19 pandemic, better use needs to be made of community medicine data. Since 2007, Inserm via its Epidemiological Center on the Medical Causes of death (CépiDc) has provided the CertDc app, which enables doctors to produce and electronically certify death certificates, and as such provide rapid notification of information on the causes of death and the profiles of the deceased (sociodemographic and administrative information). In 2019, this data channel represented only 20% of deaths on French territory, with the majority of certificates still being issued by doctors in paper format.

In the current health emergency context, the more widespread use of electronic death certification would minimize delays in accessing COVID-19 mortality data and make it possible to more rapidly obtain accurate and reliable mapping of the pandemic.

The widespread implementation of electronic death certification is therefore encouraged, with work being done to raise the awareness of the various health care players via the Regional Health Agencies, in order for all data to be notified under better time conditions. The real-time arrival of these mortality data is essential if we are to gain a better understanding of the scope of this pandemic and how best to fight it.

Researcher Contact

Grégoire Rey Inserm Directeur du Centre d’Epidémiologie sur les causes médicales de décès – CEPIDC rf.mresni@yer.eriogerg  Claire Morgand Inserm Directrice adjointe du Centre d’Epidémiologie sur les causes médicales de décès – CEPIDC rf.mresni@dnagrom.erialc

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