Background
: Death certificates are important data about death, which represent the changing pattern of disease and make it possible to compare the health status among other groups. But often there are error occurring tendencies which are due to the inaccuracy of diagnosis and inaccuracy of filling up death certificates, and which reduce the validity of death statistics. We reviewed the death certificates for the purpose of getting information about the incidence and the types of errors.

Methods : we reviewed a sample of 1047 death certificates collected at the Department of Statistics in Feb 1991. Seven items based upon WHO criteria were checked in the review, and we compared the error rate among to geographical districts, medical specialties, hospital size and year in which the physician who completed the death certificate obtain his/her medical license.

Results : One or more errors were found in 56.4% of death certificates. Of the total number of errors, 39% were due to listing the mechanism of death(such as cardiac arrest or respiratory arrest) as the immediate cause of death, 18.2% due to failing to state the immediate cause of death, 9.2% due to listing nonspecific disease entities instead of specific medical diagnosis, 8.3% due to listing illogical relationship between causes, 7.4% due to failing to state the underlying cause of death, 7.1% due to reversing the immediate and underlying cause of death, 5.6% due to part I containing conditions not or mannerly contributing to death in addition to the underlying cause of death, 2.5% to failing to certain information about E codes, 1.3% to part II containing either an underlying cause of death or a complication of the cause of death, and 1.5% to contain only the mechanism of death. We could not determine the precise underlying cause of death in 10.8%. Furthermore, up to 13.2% of death certificates may have involved inappropriate selection for the underlying cause of death. There are no differences in errors among districts, specialties, and hospital size. There are slightly more errors of death certificates recorded by the physician who obtains their licenses before 1960.

Conclusion : The accuracy of death certificates was low. So we need more attention in filling up death certificates.