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dc.contributor.authorZhao, Jiaying
dc.contributor.authorTu, Edward Jow-Ching
dc.contributor.authorLaw, Chi-kin
dc.date.accessioned2018-01-02T23:20:31Z
dc.date.available2018-01-02T23:20:31Z
dc.date.issued2017
dc.identifier.issn1478-7954
dc.identifier.doi10.1186/s12963-017-0155-z
dc.identifier.urihttp://hdl.handle.net/10072/356086
dc.description.abstractBackground Valid and comparable cause of death (COD) statistics are crucial for health policy analyses. Variations in COD assignment across geographical areas are well-documented while socio-institutional factors may affect the process of COD and underlying cause of death (UCD) determination. This study examines the comparability of UCD statistics in Hong Kong and Shanghai, having two political systems within one country, and assesses how socio-institutional factors influence UCD comparability. Methods A mixed method was used. Quantitative analyses involved anonymized official mortality records. Mortality rates were analyzed by location of death. To analyze the odds ratio of being assigned to a particular UCD, logistic regressions were performed. Qualitative analyses involved literature reviews and semi-structural interviews with key stakeholders in death registration practices. Thematic analysis was used. Results Age-standardized death rates from certain immediate conditions (e.g., septicemia, pneumonia, and renal failure) were higher in Hong Kong. Variations in UCD determination may be attributed to preference of location of death, procedures of registering deaths outside hospital, perceptions on the causal chain of COD, implications of the selected UCD for doctors’ professional performance, and governance and processes of data quality review. Conclusions Variations in socio-institutional factors were related to the process of certifying and registering COD in Hong Kong and Shanghai. To improve regional data comparability, health authorities should develop standard procedures for registering deaths outside hospital, provide guidelines and regular training for doctors, develop a unified automated coding system, consolidate a standard procedure for data review and validity checks, and disseminate information concerning both UCD and multiple causes of death.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherBioMed Central
dc.relation.ispartofpagefrom37-1
dc.relation.ispartofpageto37-12
dc.relation.ispartofjournalPopulation Health Metrics
dc.relation.ispartofvolume15
dc.subject.fieldofresearchPublic Health and Health Services not elsewhere classified
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchcode111799
dc.subject.fieldofresearchcode1117
dc.titleThe incomparability of cause of death statistics under “one country, two systems”: Shanghai versus Hong Kong
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© The Author(s) 2017. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated
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gro.griffith.authorLaw, Chi Kin


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