# Assessment of errors in death certification and mortality patterns and trends among medical patients at Korle Bu Teaching Hospital, 2019-2023

## TL;DR

This study found that most death certificates at a teaching hospital had errors, especially in reporting the underlying cause of death, and showed a high rate of deaths from non-communicable diseases.

## Contribution

The study provides a detailed audit of death certification errors and mortality trends in a medical department in Ghana.

## Key findings

- 98.17% of MCCD forms had errors, with 88.64% containing major errors.
- Non-communicable diseases were responsible for over half of recorded deaths annually.
- Cardiovascular-related conditions were the leading cause of death.

## Abstract

This study audited the Medical Certification of Cause of Death (MCCD) forms issued at Korle-Bu Teaching Hospital, assessing their accuracy, completeness, and consistency while analysing trends in mortality causes.

Retrospective review of completed MCCD forms.

Korle-Bu Teaching Hospital, Department of Medicine.

All duplicate MCCD forms issued between January 1st, 2019, and December 31st, 2023, were included.

No intervention

Frequency of major and minor errors in completing the MCCD forms and leading causes of death in the department.

Of 4,544 MCCD forms audited, 4,460 (98.17%) contained errors. Major errors were observed in 4,028 (88.64%) forms; the commonest being incorrect reporting of the underlying cause of death (3,483; 76.65%). Minor errors were nearly universal (99.82%), with omission of the full address of the deceased (4,530; 99.69%) being most frequent. Over half of the recorded deaths each year were attributable to non-communicable diseases (NCDs), with cardiovascular-related conditions being the leading cause of death.

There was a high prevalence of errors in MCCD forms, highlighting the need for regular training of healthcare professionals to improve accuracy in death certification. Additionally, the high burden of NCD-related deaths emphasises the need to address modifiable risk factors, strengthen health systems, and foster multisectoral collaboration to mitigate the growing NCD epidemic.

None declared