The accuracy of death certificates given at Kocaeli University Hospital

Amaç: Ölüm nedenleri ile ilgili kayıtlar, ülkelerin sağlık sistemlerinin en önemli bileşenlerinden biridir.Ölüm nedenlerinin güvenilirliği konusunda tüm ülkelerde ortak sorunlar yaşanmaktadır. Bu çalışmada, Kocaeli Üniversitesi Hastanesi’nden Başbakanlık Devlet İstatistik Enstitüsü’ne (DİE) bildirilen ölüm nedenleri ile hasta dosyasındaki bilgiler karşılaştırıldı. Çalışma Planı: 2002 ve 2003 yıllarında görülen ölümlere ait hasta dosyaları ve DİE’ye gönderilen ölüm formları geriye dönük olarak incelendi. Ölüm nedenleri Dünya Sağlık Örgütü’nün önerdiği ölçütlere göre temel, ara ve son neden olarak sınıflandırıldı. Hastalık listesi olarak ICD-10 kullanıldı. Bulgular: Toplam 744 ölümden her iki kaynakta da bulunan 665’i karşılaştırıldı. Bunların 211’inde (%31.7) ölüm nedeni olarak temel neden doğru yazılmıştı. Ölümlerin %24.4’ü (n=162) kardiyorespiratuvar arrest gibi başka hastalık veya durumlara, %16.8’i (n=112) ise son nedene bağlanmıştı. Ölüm sertifikaları nın 105’inde (%15.8) ilgisiz bir ölüm nedenine rastlandı. İki yüz on ölüme ait formların hatalı doldurulduğu; bunların %59.0’unda yanlış kısaltma kullanıldığı, %34.3’ünde ise hastalık listesinde bulunmayan sendrom/ hastalık adı yazıldığı saptandı. Sonuç: Ölüm formlarının doğru doldurulması için hem mezuniyet öncesi eğitim hem de uyum eğitimleri yapılmalıdır. Ayrıca, kesin ölüm nedenlerinin saptanması için patolojik otopsilerin yapılması önemlidir.Objectives: Registries for the causes of death constitute one of the basic components of health system in all countries. The reliability of the notified causes of death appears to be a common problem. In this study, we compared the information on death certificates routinely sent from the Kocaeli University Hospital to the State Statistics Institute (SSI) with that found on patient records. Study Design: A retrospective review was made on patient records and death certificates sent to the SSI in 2002 and 2003. The causes of death were classified as principal, contributing, and immediate causes according to the WHO criteria. Diagnoses were defined according to the ICD-10 list. Results: Of 744 deaths, records of 665 cases were present in both sources. Certificates of 211 cases (31.7%) included the correct principal death cause, while in 162 cases (24.4%) the deaths were attributed to other disease/conditions such as cardiorespiratory arrest, and in 112 cases, (16.8%), to an immediate cause. An irrelevant cause was found in 105 (15.8%) certificates. We detected a number of mistakes in 210 certificates, the most common being the use of inappropriate abbreviation (59.0%) and disease terms not available in the disease list (34.3%). Conclusion: The accuracy of death certificates may be improved with training programs among physicians. Furthermore, postmortem autopsy examinations are very important to determine the exact cause of death

Gender differences in self-rated health and their determinants in Turkey: A further analysis of Turkish health survey

Objective: This study analysed gender differences in self rated health status and their determinants by gender in Turkey.  Methods: This is a further analysis of a 2010 Health Survey conducted by Turkish Statistical Institute (TurkStat) A total of 5488 men and 7149 women in Turkey were included in this cross-sectional study. Self-rated health was analysed using three logistic regression models. Results: The rates of poor health were 9.8% among women and 5.2% among men, with the gender gap increasing with age. Low level of education, chronic diseases and poverty were associated with poor perceived health in both genders. For women, marriage and retirement from secure jobs were associated with good health; obesity and smoking were factors that caused poor health. For men, unemployment had a negative impact on health. Conclusion: The determinants of poor health were associated with not only on socioeconomic status but also on gender in the Turkey. Marriage may provide social protection for women where there are insufficient social policies to protect them </p

Head Circumference Charts for Turkish Children Aged Five to Eighteen Years

Introduction: Most head circumference growth references are useful during the first years of life, but they are also useful for older children when screening for developmental, neurological, and genetic disorders. We aimed to develop head circumference growth reference charts for age, height, and waist circumference for Turkish children aged 5-18 years