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3303.0 - Causes of Death, Australia, 2011 Quality Declaration 
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 15/03/2013   
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TECHNICAL NOTE 2 CAUSES OF DEATH REVISIONS PROCESS


OVERVIEW

1 There have been two process improvements implemented by the ABS in recent years which have improved the quality of data, with the biggest improvements seen in the external cause chapter and for coroner certified deaths. These processes were both implemented for the 2008 reference year. The first was a revisions process outlined in Explanatory Notes 29-33 and the second was in relation to the use of additional information from the medical certificate cause of death and from information stored within reports on the NCIS, see Explanatory Notes 56-67 for further information. The following technical note outlines the impact of these two processes.

2 Previous publications of Causes of Death, Australia indicated that all coroner certified deaths registered after 1 January 2007 are now subject to a revisions process. In order to improve the quality of historical data, the 2006 reference year data has also been revised (see Technical Notes, Causes of Death Revisions, 2006 in the Causes of Death, Australia, 2010 release). Therefore in the current release 2006 to 2009 data are final, 2010 data are revised, and 2011 data are preliminary. The 2010 and 2011 data will be subject to further revisions. Data for the 2006 reference year has not been included for analysis in this technical note because the revisions process was different to that of the 2007-2010 reference years.


PRELIMINARY CODING

3 Figure 1 illustrates preliminary data for the 2007-2011 reference years. Data shows the number of deaths allocated to codes which have no specificity of cause (R99), mechanism (X59, X84 and Y09) or intent (Y10-Y34). Over the period from 2007 to 2011 there has been:

  • a reduction in the number of deaths coded to R99 (other ill-defined and unspecified causes of mortality) from a high of 0.8% (1,160) of all deaths in 2007 to 0.4% (605 and 504) in 2009 and 2010 respectively. In 2011, there was an increase to 0.5% (703) of all deaths coded to R99.
  • a reduction in the number of deaths coded to unspecified mechanism codes (X59 - Accident, X84 - Intentional self-harm, Y09 - Assault) from 0.2% (262) of all deaths in 2008 to 0.1% of all deaths in 2009 (117), 2010 (93) and 2011 (82);
  • a reduction in the number of deaths with an undetermined intent (Y10-Y34) from 0.8% in 2007 (1,088) to 0.3% (470) in 2011.

Selected Causes of Death, Coroner Cases, Preliminary Data - Australia - 2007-2011(a)




IMPACT OF REVISIONS

4 Table 1 provides information on the impact of the revisions process for the 2009 reference year at the ICD-10 chapter level. Notable changes occurred in the following chapters:
  • Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) - reduction of 312 deaths;
  • External causes of morbidity and mortality (V01-Y98) - increase of 187 deaths;
  • Diseases of the circulatory system (I00-I99) - increase of 77 deaths.

TABLE 1 - CAUSES OF DEATH REVISIONS , (PRELIMINARY, REVISED, FINAL) - by ICD-10 chapter - 2009

2009
Change (prelim to final)
P
R
F
Cause of death and ICD-10 code
no
no
no
no
%

Certain infectious and parasitic diseases (A00-B99)
1 821
1826
1 826
5
0.3
Neoplasms (C00-D48)
41 952
41 946
41 965
13
0.0
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism D50-D89
428
430
429
1
0.2
Endocrine, nutritional and metabolic diseases (E00-E90)
5 867
5 880
5 883
16
0.3
Mental and behavioural disorders (F00-F99)
6 522
6 516
6 518
-4
-0.1
Diseases of the nervous system (G00-G99)
5 906
5 911
5 909
3
0.1
Diseases of the circulatory system (I00-I99)
46 106
46 188
46 183
77
0.2
Diseases of the respiratory system (J00-J99)
11 049
11 051
11 045
-4
0.0
Diseases of the digestive system (K00-K93)
5 011
5 017
5 014
3
0.1
Diseases of the skin and subcutaneous tissue (L00-L99)
383
385
386
3
0.8
Diseases of the musculoskeletal system and connective tissue (MOO-M99)
1 078
1 080
1 078
0
0.0
Diseases of the genitourinary system (N00-N99)
3 405
3 409
3 409
4
0.1
Certain conditions originating in the perinatal period (P00-P96)
656
655
654
-2
-0.3
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
632
637
638
6
0.9
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
1 045
751
733
-312
-29.9
External causes of morbidity and mortality (V01-Y98)
8 884
9 043
9 071
187
2.1
Total(a)
140 760
140 760
140 760
0
0.0

(a) Includes deaths coded to H00-H59, H60-H95, and O00-O99.


5 Table 2 shows a comparison of change, from preliminary to final, for 2007 and 2008. There was a 46.4% decrease in the number of deaths attributed to Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) for the 2007 reference year, while there was a 31.4% decrease for the 2008 reference year. This is consistent with previous findings that show more specific codes have been allocated in preliminary coding.

TABLE 2 - CAUSES OF DEATH REVISIONS, by selected ICD-10 chapter - changes from preliminary to final data: by percentage - 2007, 2008 and 2009

2007
2008
2009
Cause of death and ICD-10 code
%
%
%

Certain infectious and parasitic diseases (A00-B99)
-0.1
1.8
0.3
Neoplasms (C00-D48)
0.1
0.0
0.0
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism D50-D89
0.8
0.2
0.2
Endocrine, nutritional and metabolic diseases (E00-E90)
0.5
-0.2
0.3
Mental and behavioural disorders (F00-F99)
-0.4
-0.5
-0.1
Diseases of the nervous system (G00-G99)
0.3
0.4
0.1
Diseases of the circulatory system (I00-I99)
0.7
0.4
0.2
Diseases of the respiratory system (J00-J99)
0.4
0.1
0.0
Diseases of the digestive system (K00-K93)
0.9
0.6
0.1
Diseases of the skin and subcutaneous tissue (L00-L99)
0.6
-0.5
0.8
Diseases of the musculoskeletal system and connective tissue (MOO-M99)
1.3
-0.7
0.0
Diseases of the genitourinary system (N00-N99)
0.2
0.4
0.1
Certain conditions originating in the perinatal period (P00-P96)
1.6
0.2
-0.3
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
3.7
0.8
0.9
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
-46.4
-31.4
-29.9
External causes of morbidity and mortality (V01-Y98)
4.3
1.1
2.1



6 Table 3 provides information on the impact of revisions on 2009 data at the sub-chapter level with the following notable reductions:
  • Event of undetermined intent (Y10-Y34)(603 deaths);
  • Other ill-defined and unspecified causes of mortality (R99) (333 deaths);
  • Other land transport accidents (V80-V89) (44 deaths)

Notable increases include:
  • Accidental poisoning by and exposure to noxious substances (X40-X49)(205 deaths);
  • Intentional self-harm (X60-X84) (205 deaths);
  • Car occupant injured in transport accident (V40-V49) (110 deaths);
  • Falls (W00-W19) (80 deaths);
  • Assault (X85-Y09) (62 deaths).
TABLE 3: CAUSES OF DEATH REVISIONS (PRELIMINARY, REVISED, FINAL), by ICD-10 selected causes - 2009

2009
Change (preliminary to final)
Preliminary
Revised
Final
Cause of death and ICD-10 code
no.
no.
no.
no
%

Sudden infant death syndrome (R95)
78
93
95
17
21.8
Other ill-defined and unspecified causes of mortality (R99)
649
337
316
-333
-51.3
Pedestrian injured in transport accident (V01-V09)
194
236
243
49
25.3
Pedal cyclist injured in transport accident (V10-V19)
35
38
37
2
5.7
Motorcycle rider injured in transport accident (V20-V29)
211
239
242
31
14.7
Car occupant injured in transport accident (V40-V49)
743
819
853
110
14.8
Occupant of pick-up truck or van injured in transport accident (V50-V59)
58
72
79
21
36.2
Occupant of heavy transport vehicle injured in transport accident (V60-V69)
40
41
44
4
10.0
Other land transport accidents (V80-V89)
127
84
83
-44
-34.6
Water transport accidents (V90-V94)
35
45
48
13
37.1
Air and space transport accidents (V95-V97)
27
30
33
6
22.2
Falls (W00-W19)
1 370
1 435
1 450
80
5.8
Exposure to inanimate mechanical forces (W20-W49)
83
85
83
0
0.0
Accidental drowning and submersion (W65-W74)
182
194
200
18
9.9
Other accidental threats to breathing (W75-W84)
220
232
232
12
5.5
Exposure to smoke, fire and flames (X00-X09)
218
224
227
9
4.1
Exposure to forces of nature (X30-X39)
81
84
85
3
4.9
Accidental poisoning by and exposure to noxious substances (X40-X49)
799
964
1 004
205
25.7
Accidental exposure to other and unspecified factors (X58-X59)
717
708
709
-8
-1.1
Intentional self-harm (X60-X84)(a)
2 130
2 284
2 335
205
9.6
Assault (X85-Y09)
210
261
272
62
29.5
Event of undetermined intent (Y10-Y34)
993
547
390
-603
-60.7
Drugs, medicaments and biological substances causing adverse effects in therapeutic use (Y40-Y59)
58
57
57
-1
-1.7
Surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure (Y83-Y84)
141
148
150
9
6.4
Sequelae of external causes of morbidity and mortality (Y85-Y89)
159
155
153
-6
-3.8


(a) Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 92-95.


8 Table 4 shows the percentage change between preliminary and final data for 2007, 2008 and 2009 data at the sub-chapter level. Notable changes due to the revisions process include:
  • Deaths due to intentional self-harm increased by 18.5% (347 deaths) between preliminary and final coding for the 2007 reference year, but saw a smaller increase of 6.8% (150 deaths) in the 2008 reference year.
  • Deaths due to event of undetermined intent decreased by 66.7% (726 deaths) and 57.7% (671 deaths) for the 2007 and 2008 reference years.

TABLE 4 - Cause of Death Revisions, by ICD-10 selected causes - Percentage change between preliminary and final data - 2007, 2008 and 2009

Cause of death and ICD-10 code
2007
2008
2009

Sudden infant death syndrome (R95)
15.5
30.5
21.8
Other ill-defined and unspecified causes of mortality (R99)
-68.1
-46.5
-51.3
Pedestrian injured in transport accident (V01-V09)
26.9
24.6
25.3
Pedal cyclist injured in transport accident (V10-V19)
32.4
16.7
5.7
Motorcycle rider injured in transport accident (V20-V29)
25.0
19.5
14.7
Car occupant injured in transport accident (V40-V49)
20.8
11.7
14.8
Occupant of pick-up truck or van injured in transport accident (V50-V59)
39.6
102.9
36.2
Occupant of heavy transport vehicle injured in transport accident (V60-V69)
56.3
26.8
10.0
Other land transport accidents (V80-V89)
84.5
3.7
-34.6
Water transport accidents (V90-V94)
16.1
15.6
37.1
Air and space transport accidents (V95-V97)
47.2
9.1
22.2
Falls (W00-W19)
12.4
8.4
5.8
Exposure to inanimate mechanical forces (W20-W49)
30.5
17.6
0.0
Accidental drowning and submersion (W65-W74)
4.4
15.7
9.9
Other accidental threats to breathing (W75-W84)
4.1
7.7
5.5
Exposure to smoke, fire and flames (X00-X09)
24.1
16.7
4.1
Exposure to forces of nature (X30-X39)
5.8
3.4
4.9
Accidental poisoning by and exposure to noxious substances (X40-X49)
32.7
40.8
25.7
Accidental exposure to other and unspecified factors (X58-X59)
-18.2
-12.3
-1.1
Intentional self-harm (X60-X84)(a)
18.5
6.8
9.6
Assault (X85-Y09)
33.3
23.6
29.5
Event of undetermined intent (Y10-Y34)
-66.7
-57.7
-60.7
Drugs, medicaments and biological substances causing adverse effects in therapeutic use (Y40-Y59)
1.7
6.3
-1.7
Surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure (Y83-Y84)
-2.1
-3.2
6.4
Sequelae of external causes of morbidity and mortality (Y85-Y89)
2.1
-1.9
-3.8

(a) Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 92-95.


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