Hungarian Central Statistical Office

Population Census and Demographic Statistics Department

H-1024 Budapest, Keleti K. u. 5-7.

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 chain 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).

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

Classification and updates applied by years

Public Health.

Concepts and definitions are described in the Commission regulation (EU) No 328/2011 in articles 2 and 3.

Resident population: the total number of persons having a residence on the respective area and having no place of stay elsewhere as well as of persons having a place of stay on the same area. Place of residence: the address of the dwelling in which the citizen lives. From the point of view of the registration of the home address the following can be considered as a dwelling: a building or a part of building, consisting of one or more living premises, used by the citizen as home as well as the room where somebody lives in need or lodges if he/she has no other dwelling. Place of stay: the address of the dwelling where a person stays longer than three months without the intention to leave finally place of residence.

If after the separation from the mother's body the foetus did not show any sign of life and if from the conception longer than 24 complete weeks passed or if the age of the foetus cannot be stated, the lenght of the foetus is 30 cm or more or if the weight of the foetus is 500 g or more, while in case of twin birth if at least one of the foetus' born alive. 

Social-demographic information about the female (the mother) and the following: 1. Place of death (outside/in an institute); 2. When did the foetus die? (before delivery, in the phase of dilatation, in the phase of explusion); 3. Date of death; 4. Gestational age, weight, crown-heel length; 5. Single or multiple foetus? Which in the sequence? 6. Sex; 7. Congenital malformations (2); 8. The way of starting of the delivery (spontaneous, induced delivery, programmed delivery, elective cesarean, other); 9. Cause of death: maternal conditions (2), foetal conditions (2); 10. Status of the child-bearing female (recovered, needs a further therapy, died); 11. Number of hospitalization days; 12. Date of discharge. (We collect similar but less information about early and medium foetal deaths. Since the national definition differs from Eurostat, some early and medium foetal deaths are also sent to Eurostat database.)

The statistical unit is the deceased person and the stillborns, respectively.

Statistical population is defined by residents and non-residents who died in Hungary.

They are considered by the place of resident of the mother.

Non-residents are included.

If the death of a national resident is abroad is registered in Hungary; the main demographic information is available (sex, age, marital status, place of residence in Hungary). However it is not comprehensive information, therefore it is not published in the national statistics.

Hungary.

Time series available from 1994 onwards.

Not applicable.

The unit is number.

Data refer to the  year 2021, all deaths occuring during the year.

CoD data was submitted 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.

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. 

CoD data according to this regulation is submitted to Eurostat since reference year 2011.

Data transfer: Act nr. XLVII of 1997 on the handling and protection of health and related personal data pursuant to Paragraphs 16. (8), (11) and 20 (3a), the HCSO forwards the personally identifiable mortality data and disease registers to governing bodies and public health administrations.

The purpose of the data trasnfer is to promote effective treatment activities, includning professional supervision and monitoring of health status of data subject furthermore the medical-professional and epidemiological examination as well as planning and organizing health care and budget planning.

In data management and related activities, the HCSO acts in compliance with Act CLV of 2016 on Official Statistics and Act CXII of 2011 on Informational Self-determination and Freedom of Information, and in accordance with the data protection practices developed by the Hungarian National Authority for Data Protection and Freedom of Information. Further, the HCSO also takes into consideration the prescriptions of the Regulation (EU) No 679/2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation).

Confidentiality policy is available on the website of HCSO:

http://www.ksh.hu/docs/bemutatkozas/eng/avpol_web_eng.pdf.

The basic condition for the activities of the HCSO is to maintain the trust of data providers. The most important guarantee of this, is the strict protection of data provided for statistical purposes. Firstly in purpose of data protection, it is only obligatory to provide data to the HCSO if it has been ordered by law and its exact content has been determined.

The Data Protection Committee, which includes experts in the legal, methodological, IT and information fields, as a decision-making and advisory body of the President of the HCSO supervises, organizes, coordinates and monitors the enforcement of data protection rules in the course of the activities of the HCSO, thus ensuring the publicity of data of public interest and the protection of individual data.

More information is available on the link attached below:

 http://www.ksh.hu/docs/bemutatkozas/eng/avpol_web_eng.pdf.

Final Cod data is disseminated at national level after 8 months of the end of the reference year.

Wide scope of final data are published in the Statistical Yearbook of Hungary in August, while the Demographic Yearbook is available in October.

More information is available on the link attached below.

http://www.ksh.hu/katalogus/#/en

More information is available on the link attached below.

http://www.ksh.hu/katalogus/#/en

 Anyone can submit a request to the HCSO for access to the statistical data managed by the HCSO. Data may be sent to international organizations with the permission of the head of the department responsible for the data.

More information is available on the link attached below:

http://www.ksh.hu/docs/bemutatkozas/eng/tajpol_web_eng.pdf

Further details on the different data access channels can be found at the link below:

http://www.ksh.hu/data_request_data_claim_fulfilment

Annual.

News releases on-line.

Demographic Yearbook, Statistical Yearbook of Hungary, Summary Tables (STADAT) and written analysis in non-regular publications.

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

Dissemination Database is available on the HCSO website: www.ksh.hu

Our webstatistics refer to the whole vital statistical subject. However most of the data consulations concerns the population and the causes of deaths.

Average number of data consultations through the website of HCSO per month, all vital statistical subjects together, Hungarian/English version: 5520/410

Microdata is usually provided for some institutes determined by law for public health purpose. Individual data request is also possible according to the conditions published at our website, these are usually considered uniquely. For scientific purpose microdata can be obtained through the Safe Centre Access.

Not available.

For the reference years 2014-2018 the information is not available.

Documents for COD data are available on the website of HCSO.

National metadata information is available here: http://www.ksh.hu/apps/meta.objektum?p_lang=EN&p_menu_id=110&p_ot_id=100&p_obj_id=WNH&p_session_id=10645482

The metadata documentation is complete.

Metadata on causes of death statistics are available on the website of the Statistical Office:

http://www.ksh.hu/apps/meta.menu?p_lang=EN&p_menu_id=110&p_session_id=24716643.

The policy of HCSO regarding quality management can be found on the links below:

http://www.ksh.hu/docs/bemutatkozas/eng/minpol_web_eng.pdf,

 The general quality policy of the statistical office and the information related to the quality guide can be found on the following links: 

http://www.ksh.hu/docs/bemutatkozas/eng/minosegi_iranyelvek_eng.pdf

http://www.ksh.hu/docs/bemutatkozas/eng/minpol_web_eng.pdf

 The metadata description also includes a section on the quality of mortality statistics as well, which is available on the link attached below:

http://www.ksh.hu/apps/meta.objektum?p_lang=EN&p_menu_id=110&p_almenu_id=105&p_ot_id=100&p_obj_id=AABB

Mortality statistics are used by national and local governments to formulate public health policy, define its objectives, evaluate the health system, and use it for scientific and educational purposes by researchers, clinicians, and educational institutions.

Mortality data are key indicators for measuring and comparing the health system in local, national, and international contexts.

 The HCSO considers it important to carry out its activities taking into account the needs of users, therefore it regularly examines user needs and user satisfaction in order to establish developments. According to Principle 3 of the Codex of Practice for National Statistics user needs are at the center of the operation of statistical organizations that develop, produce and publish official statistics. In line with the above, the HCSO's medium-term strategy (Strategy 2020, Strategy 2030) set as a primary goal the satisfaction of high-quality user needs and the development of services.

There was no topic-specific satisfaction survey on mortality data.

All Causes of death data, about the residents and non-residents who died in Hungary, are disseminated to ESTAT.

1. For mandatory variables:

All mandatory variables required by the Commission regulation n°328/2011 are transmitted to the European Commission. Data about the residents dying abroad are transmitted except the cause of death information, because we never receive the Death Certificates from the country of occurence. However it concerned only on average 0,3% of all deaths of the 2014-2018 years.

2. For voluntary variables:

All voluntary variables required by the Commission regulation n°328/2011 are transmitted to the European Commission.

3. For additional variables:

• External CoD

 All external CoD variables required by the Commission regulation n°328/2011 are transmitted to the European Comission.

• Place of occurrence for external CoD

 All places of occurence for external CoD required by the Commission regulation n°328/2011 are transmitted to the European Comission.

• Activity for external CoD

 Activity for external CoD variable is not applicable.

The data related to deaths occurred in Hungary are fully comprehensive and accurate. The data referring to the deaths of Hungarian residents in abroad are less detailed.

Not applicable. Data collection is from administrative sources.

Not applicable.

There is a coverage error because of late registration of residents' deaths in abroad.

There is a lag in the registration of deaths occurred in other countries. Sometimes the delay is so long, that the case cannot be included in the statistics.

Under coverage: There are national residents died abroad who are not covered by the statistics, they take on average 0.2 per cent of the total number of deaths in 2014-2018. The reason for that is the deadline of t+6 months of the national data publication (population and vital statistics), threfore the data arriving later cannot be included into the statistics.

Not applicable. Data collection is from administrative sources.

Not applicable.

The non response error is very low.

The rate of the residents died abroad that were not counted because of time lag in the registration: on average 0.2 per cent in 2014-2018.

For all residents died abroad the cause of death information is missing (on average 0.3 per cent of total number of deaths in 2014-2018).

Not applicable.

Not applicable.

Mortality and infant mortality:

Preliminary annual data without causes of death: t+60 days.

Cause of death data:

Preliminary annual data: t+5 months.

Mortality and infant mortality:

Final data without causes of death: t+6 months.

Cause of death data:

Final, but less detailed cause of death data is published in t+8 months.

Final and deatiled cause of death data is published in t+10 months.

From data collection with reference year 2011 onwards, Eurostat asks for the submission of final data at national and regional level and related metadata for the year N at N+24 months, according to the Implementing Regulation (EC) No. 328/2011, Article 4.

The data are usually published before the target date.

The coherence of two or more statistical outputs refers to the degree to which the statistical processes, by which they were generated, used the same concepts and harmonised methods.

The national definition for stillbirths differs from the European one. According to the national definition a late foetal death: If after the separation from the mother's body the foetus did not show any sign of life and if from the conception longer than 24 complete weeks passed or if the age of the foetus cannot be stated, the lenght of the foetus is 30 cm or more or if the weight of the foetus is 500 g or more, while in case of twin birth if at least one of the foetus' born alive.

The data about stillbiths are transmitted to te European Commission according to the Commission regulation n°328/2011, therefore the national definition concernes only the national publications.

 Geographical breakdown of all causes of death data is in line with NUTS classification, therefore data are comparable at international and at national level.

Not applicable.

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 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.

The last break in the time series was in 2005 because of the implementation of a new Death Certificate and an automated coding system. Its impact was analized in dept by a bridge-coding study. 

The lenght of comparable time series from 2005:

- 10 years (till 2014), 11 years (till 2015), 12 years (till 2016), 13 years (till 2017), 14 years (till 2018)

The mortality data are fully in line with the number of deaths occured in Hungary, but there is no cause of death information about national residents died abroad.(0,56 per cent of the total number of deaths in 2021).

Not applicable, only annual data are available.

Not applicable.

For stillbirths, perinatal deaths and general mortality data come from different sources, also the processing is carried out by different devices however the data are coherent.

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

There are routine, scheduled revisions when the preliminary data are finalized. Occasionally non-scheduled revisions are performed if an unforseeable event makes them necessary.

More information is available on the link attached below:

http://www.ksh.hu/docs/bemutatkozas/eng/ksh_revizios_politikaja_2018_eng.pdf

The preliminary annual data will be finalized by the end of the eight month following the reference year.

The size of revision of the number of death is usually 1,02–1,04.

The source of data are civil registrars and health institutions. National statistical data collection is carried out through the following forms:

1. Death Record,

2. Death Certificate,

3. Perinatal Death Certificate,

4. Foetal Death Record,

5. Notice about the Modification of the Death Certificate,

6. Notice about Autopsy of Perinatal Deceased

Continuous.

The Death Certificate and the Perinatal Death Certificate are always filled out by a physician. If the circumstances indicate a non-natural death a forensic physician has to be involved. If the cause of death cannot be stated and for all perinatal cases an autopsy has to be performed. When the certificate is completely filled out it has to be transferred to the registrar.

The Death Record (about socio-demographic information) is filled out by the registrar.

One copy of the certificate and the Death Record are tarnsmitted together to the local Deapartment of the HCSO responsible for vital statistical data entry. The statisticians check all the certificates. If a certification error is detected the querying is performed by the local health officer. The data entry is carried out by the local Departments of the HCSO. The medical text of death causes is recorded literally, all other information are coded.

The instructions of ICD-10 Volume 2 are used. Incorrect sequences and missing information are detected and queried.

In the medical universities the training in certification is included in the curriculum.

Table on certification (Percentage)

a) Stillbirths

We use the Foetal Death Record and the Perinatal Death Certificate (WHO standard). All stillbith cases are coded manually by using all information available.

b) Neonates

For deaths occurred in the age of 0-6 days of live birth infants the Perinatal Death Certificate is used. The coding is performed according to the WHO guidelines regarding perinatal deaths.

Neonatal deaths from the age of 7 days are certified and coded in the same way like other deaths.

During data processing quality and consistency checkings (dual record check) are carried out in order to handle, logical contradictions and errors in records.

The validation is based on the registry number.

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

 Stillbirths and perinatal deaths are coded manually, other cases are processed by an automated coding system. There is a manual check for malignant neoplasms, external causes, infant deaths and maternal deaths. The final data is usually checked by using the IRIS system.

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):

 By means of the error detection procedures the inconsistencies in the deceased's age, sex and the causes of death are filtered in. If an error is discovered the original death certificate is checked.

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

 The errors are corrected by the coders or by querying the certifier (it depends on the type of the error). At some cases, if the certifier confirms his/her previous statement, the error is approved.

Coding performed by a certifier:

 No, the coders are statisticians.

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

The autopsy rate is 23 per cent. The information is available for coding in 98 per cent. In about 2 per cent of the autopsies the result do not arrive before closing the statistical database.

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

 Double coding excersises are not performed.

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

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

During data processing quality and consistency checkings (dual record check) are carried out in order to handle e.g. logical contradictions and errors in records.

The coverage is ensured by registration of deaths (by the registration number).

The data are collected by civil registrars and health institutions and than compiled by the Hungarian Central Statistical Office. Here coding, editing and correction are carried out. The final verified data are loaded into the Demographic Database, than the tables are prepared on this basis.

Not applicable.

There's no adjustment on death statistics.

Not applicable.

None.