Standardization of requirements to structure of diagnosis – a key element in improving morbidity statistics and causes of death in population
AbstractDiagnosis structure should include the following headings: "main disease", "complications of the underlying disease" and "comorbidities". Section "main disease" includes only disease (or condition), which was the reason for diagnostic and treatment activities during the last episode of care, and might lead to death by itself or due to its complications. This disease (or condition) is reported and encoded in Part I of the medical death certificate as the primary cause of death. Direct cause of death (or fatal complication) and so-called intermediate conditions, which are selected from section "Complications of underlying disease", but not encoded, are reported in relevant paragraphs of Part I of the death certificate. In case of comorbidities other important diseases (or conditions), which were the reason for medical care, or predisposed to death in case of lethal outcome, defined as competing, intercurrent and/or underlying, are reported in the diagnosis in additional category after section "main disease" and described, respectively in Part II of the medical death certificate with appropriate codes according to ICD-10. Comorbidities (or coexisting conditions) are not reported in the medical certificate of death and are not coded as ones not having causal relationship with main disease, and not influencing lethal outcome in case of death.
Keywords:structure of the diagnosis, the medical certificate of death, morbidity and mortality statistics, comorbidities