Federal Statistical Office, Germany

Health Statistics

Graurheindorfer Straße 198, 53117 Bonn

 Data on causes of death (CoD) provide information on mortality patterns and form a major element of public health information. CoD data refer to the underlying cause which - according to the World Health Organisation (WHO) - is "the disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury". CoD data are derived from death certificates. The information provided in the medical certificate of cause of death is mapped to the International Statistical Classification of Diseases and Related Health Problems (ICD). 

Eurostat's CoD statistics build on standards set out by the World Health Organisation (WHO) in the International Statistical Classification of Diseases and Related Health Problems (ICD).

The regional breakdown is based on the Nomenclature of Territorial Units for Statistics (NUTS 2).

Classification and updates applied by years

Public Health

No additional definitions.

Person at place of single or main housing, registered according to the population registration regulations (obligation to register after stay of 2 months in Germany)

Child showed no sign of life and its weight is at least 500g.

The statistical unit is the deceased person respectively the stillbirths.

The average population of the reference year.

Since 1st January 2000 it is  possible that these children have german citizenship (if mother or father lives at least 8 years legally in Germany and has a residence permit).Births to women  with foreign citizenship and fathers with german citizenship are classified as having german citizenship. Births to women with german citizenship and fathers with foreign citizenship are classified as having german citizenship since 1974.text]

According to the requirements set in the Commission regulation n°328/2011, the data on non-residents who died in the country are transmitted to the European Commission.
Non-residents are not included in the national statistics.

There is the possibility of a subsequent certification of the death on base of the death certificates from  abroad (§ 36 Personenstandsgesetz). After this certification, the person who died abroad is registered in the Statisitic of Causes of Death. The quality of the data depends on the abroad certification of death.

Germany, The Federal Laender

Time series available from 1992 onwards.

Note that due to the fact that 2011 data is the first data collection with a legal basis (and few changes in the requested variables and breakdowns), the data before and after 2011 are not always comparable (In part due to the different groupings of causes of deaths). Moreover time series for data on stillbirths starts in 2011 and no information on previous data is available.

Not applicable.

The unit is number.

2021

Countries submitted data to Eurostat on the basis of a gentleman's agreement established in the framework Eurostat's Working Group on "Public Health Statistics" until data with reference year 2010. The first data submitted according to the Regulation (EU) No 328/2011 is data with reference year 2011.
A Regulation on Community statistics on public health and health and safety at work (EC) No 1338/2008 was signed by the European Parliament and the Council on 16 December 2008. This Regulation is the framework of the data collection on the domain.
Within the context of this framework Regulation, a Regulation on Community statistics on public health and health and safety at work, as regards statistics on causes of death (EU) No 328/2011 was signed by the European Parliament and the Council on 5 April 2011.

Eurostat, WHO, National Health Institutions, Scientific Resarchs Institutes, Media, broad public.

Law on Personal Data Protection

All age groups showing a total mortality of less than 4 cases are considered as confidential. Therefore, any 'confidential' agegroup is grouped with another one to have higher numbers. In practice, this problem mainly occurs for young ages so, either the ages from 0 to 14 years old, or the ages from 0 to 14 and 15 to 24 years old are grouped. The age groups considered as confidential show then the value ':' and the age group '0-14y' (and '15-24y' if needed) shows the sum of all ages before 15 years old (or between 15 and 24 years old). In addition, special measures for ensuring confidentiality may be taken for small countries.

For stillbirth and neonatal figures, no breakdown by parity is displayed to ensure confidentiality.

If the data is fully plausible, it will be published immediately in a press release

Not applicable.

Not applicable.

At the moment the data is fully plausible, it will be published immediately in a press release.

Annual.

News releases on-line.

On the website of the Federal Statistical Office.

Please consult free data on-line or refer to contact details.

Not yet available.

Microdata can be obtained from the Federal research data center. All details you find at

 www.forschungsdatenzentrum.de

https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Gesundheit/_inhalt.html

Not yet available.

National Quality Report. https://www.destatis.de/DE/Methoden/Qualitaet/Qualitaetsberichte/Gesundheit/todesursachen.pdf?__blob=publicationFile

100%.

Internal procedure between the Statistical office and the Laender.

The causes of death data are based on a regulation, which defines scope, definitions of variables and characteristics of the data.

Not available.

Not available.

Not available.

All content-related requirements oft he relevant laws, regulation and guidelines are fulfilled.

1. For mandatory variables:

100%

2. For voluntary variables:

3. For additional variables:

• External CoD: 
  

           100%

• Place of occurrence for external CoD:
  

• Activity for external CoD:

           0%

There are no reasons for any unreliability of the data.

Not applicable

Not applicable

Not applicable.

Unknown

Not applicable

Not applicable

Not applicable

Not applicable

Not applicable

Not applicable

Not known

Not applicable

Not applicable.

Not applicable.

With the exception of the years 2011 (+1 month) and 2016 (+1 month), the data was always delivered on time within the Eurostat specifications

 The data are comparable for all territorial regions in the country. The process of collecting, coding and transmission of the data is the same for all regions.

Well comparable.

The data of the referenceyYear 2011 is the first data collection with a legal basis (and few changes in the requested variables and breakdowns), the data between 1994-2010 and starting from 2011 are not always comparable (In part due to the different groupings of causes of deaths). Moreover time series for data on stillbirths starts in 2011 and no information on previous data is available.

Since 2011.

The Causes of death data are compared with the data on the population.

There are no sub annual statistics yet

Not applicable.

There is not any inconsistency in the data.

The cost and burden of the data collection is reduced by using validation and dissemination IT tools.

Regular revision based on the current  guidelines of the ICD-10 and the adoption of it.

Depending on the changes of the ICD-10.

In coordination with the collaboration-center BfArM.

All deceased with residence in Germany or the EU

Yearly

Annual full survey. Data are based on the death certificates Data source on causes of death statistics is the medical certificate of death. The form and content of thedocument are determined by the Ordinance № 42 of 8 December 2004 the Minister of Health, as the part ofthe causes of death and other medical information is standardized in accordance with the recommendationsof the World Health Organization (WHO).
The death certificate is filled in by the physician who recognized the death in accordance with theAmendment and supplement of Ordinance № 14/2004 of the Ministry of Health on medical criteria andprocedures for the identifying death, publ., SG 41 of 21.05.2019. The national legislation determines indetails all the precedures and medical criteria needed in order to identify the person as deceased
Supervision and control of the certification process is carried out by experts in Regional health inspectionsoccasionally or ad hoc on a specific issue.
The training in certification is part of the medical education.

Table on certification (Percentage)

Stillbirths are registered using birth certificates. Neonatal deaths are registered as births first and then additional as death, using birth and death certiticates.

Data validation is a continuous and ongoing work. There are three ways to make sure, that the data is of high quality.

1.            Annual training for coders:

Every year all coders are trained by experts from the WHO-collaboration center in Germany. In this training the coders learn all new rules and codes, they also have changing topics for intensive learning.

2.            Ring-coding-study

The Federal Statistical Office send out five death certificates every month to all Federal States. All coders are advised to send back there underlying cause of death. With the beginning of the next month the coders get new death certificates and the results from the month before with a reference result from the WHO-collaboration center.

3.            Use of Iris/MUSE

More than 50% of all death certificates are coded automatically by Iris/MUSE. This is the best way to make sure, that the data is of high quality.

Description of coding procedure (central level, distributed among other bodies, etc.):

The Federal States are responsible for the coding of the death certificates. All coders get a annual training and have the possibility to take part in the monthly ring-coding-study.

Description of the procedures to detect errors (i.e.errors such as potential inconsistency in the death certificate or error due to mistake when filling the deaths certificates):

Description of the measures taken in order to solve detected errors:

Coding performed by a certifier:

Estimation of the percentage of autopsy from which information is available for coding:

The autopsy-rate in Germany is very low, there are no robust data about the percentage. We estimate the rate between 1% and 3%. There is no automatism that makes sure, that the result from an autopsy will be send to the Federal States.  

Description of double coding exercises and rate of codification errors for underlying cause of death

Non-specific codes are recorded with unknown cause of death

ICD codes for the underlying cause (% of the Total)

 Unknown country/region (%) for residents and non-residents who died in the country

Not necessary because it is a full survey

The data is compiled when all federal states have supplied the data.

Not necessary because it is a full survey.

Not applicable.

Not applicable.