In May and June 2010, a total of 521 physician residents from 38 residency programs in New York City participated in an anonymous, web-based survey on the cause-of-death reporting system.
The study found only 33 percent of respondents believed cause-of-death reporting is accurate, and 49 percent had knowingly reported an inaccurate cause of death.
Of those respondents who said they reported an inaccurate cause, 77 percent said the system would not accept the correct cause, 41 percent said admitting office personnel told them to “put something else” and 31 percent said the medical examiner instructed them to do so.
Sixty-five percent of respondents said cardiovascular disease was the most frequent inaccurately reported diagnosis.
This is the first comprehensive survey of medical residents on the current cause-of-death reporting system, and it is the first to document that physicians completing death certificates often knowingly complete them inaccurately.
“These errors may have lasting effects on the public health priorities of the community,” study authors concluded. “Reform is needed both in the training and education of residents and in the system itself. We hope these findings will contribute to improvements in the cause-of-death reporting system and eventually more appropriate distribution of healthcare dollars.”
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