1.1. Contact organisation
Statistics Netherlands
1.2. Contact organisation unit
Health and Welfare
1.3. Contact name
Confidential because of GDPR
1.4. Contact person function
Confidential because of GDPR
1.5. Contact mail address
Henri Faasdreef 312, 2490 HA Den Haag, The Netherlands
1.6. Contact email address
Confidential because of GDPR
1.7. Contact phone number
Confidential because of GDPR
1.8. Contact fax number
Confidential because of GDPR
2.1. Metadata last certified
23 April 2025
2.2. Metadata last posted
23 April 2025
2.3. Metadata last update
23 April 2025
3.1. Data description
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 medical certification of death is an obligation in the Netherlands. Statistcs Netherlands codes the information provided in the medical certificate of cause of death into ICD codes according to the rules specified in the ICD.
3.2. Classification system
| Data year | ICD revision used (ICD-8, ICD-9, ICD-10) | For ICD-10: updates used |
|---|---|---|
| 1990 | ICD-9 | |
| 1991 | ICD-9 | |
| 1992 | ICD-9 | |
| 1993 | ICD-9 | |
| 1994 | ICD-9 | |
| 1995 | ICD-9 | |
| 1996 | ICD-10 | 1992 |
| 1997 | ICD-10 | 1992 |
| 1998 | ICD-10 | 1992 |
| 1999 | ICD-10 | 1992 |
| 2000 | ICD-10 | 1992 |
| 2001 | ICD-10 | 1992 |
| 2002 | ICD-10 | 1992 |
| 2003 | ICD-10 | 1992 |
| 2004 | ICD-10 | 1992 |
| 2005 | ICD-10 | 1992 |
| 2006 | ICD-10 | 1992 |
| 2007 | ICD-10 | 1992 |
| 2008 | ICD-10 | 1992 |
| 2009 | ICD-10 | 1992 |
| 2010 | ICD-10 | 1992 |
| 2011 | ICD-10 | 1992 |
| 2012 | ICD-10 | 1992 |
| 2013 | ICD-10 | 2013 |
| 2014 | ICD-10 | 2014 |
| 2015 | ICD-10 | 2015 |
| 2016 | ICD-10 | 2016 |
| 2017 | ICD-10 | 2017 |
| 2018 | ICD-10 | 2018 |
| 2019 | ICD-10 | 2018 |
| 2020 | ICD-10 | 2019 |
| 2021 | ICD-10 | 2019 |
| 2022 | ICD-10 | 2019 |
| 2023 | ICD-10 | 2019 |
3.3. Coverage - sector
Public Health.
3.4. Statistical concepts and definitions
Concepts and definitions are described in the Commission regulation (EU) No 328/2011 in articles 2 and 3.
3.4.1. National definition used for usual residency
The usual residency in the population statistics compiled by Statistics Netherlands are the people registered in the population register.
3.4.2. Stillbirth definition and characteristics collected
A stillbirth is a fetus who was born lifeless after an gestational age of at least 24 weeks. Within this dataset only the stillbirth second group (gestational age of at least 27 weeks) are included.
3.5. Statistical unit
The statistical unit is the deceased person and the stillborns.
3.6. Statistical population
Residents, non-residents and stillbirhts.
3.6.1. Neonates of non-resident mothers
They are not considered residents
3.6.2. Non-residents
Non-residents are not included in the national statistics, but are included in this data delivery.
3.6.3. Residents dying abroad
Data is recorded in the population register, but in most cases the cause of death is unknown.
3.7. Reference area
All people registrered in Dutch population register, died in the Netherlands as well as abroad. And all other persons deceased in the Netherlands but not registered in Dutch population register.
3.8. Coverage - Time
Time series are available from 1994 onwards. Time series for data on stillbirths starts in 2011 and no information on previous data is available.
3.9. Base period
Not applicable.
The data are provided in absolute numbers only.
Data refer to the calendar year 2023 (i.e. all deaths occurring during the year 2023).
6.1. Institutional Mandate - legal acts and other agreements
Statistics Netherlands is in the Netherlands the institute who receives and processes the cause of death forms. This is stated in the burial act.
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.
6.2. Institutional Mandate - data sharing
Data sharing by Statistics Netherlands is regulated in the CBS law.
Common specifications with the World Health Organisation (WHO) were used in the data collection up to 2010; in addition, Eurostat asks for NUTS level 2. From 2011 onwards, Eurostat changed the specifications to take into account the data collected through the Regulation No 328/2011.
7.1. Confidentiality - policy
Regulation (EC) No 223/2009 on European statistics (recital 24 and Article 20(4)) of 11 March 2009 (OJ L 87, p. 164), stipulates the need to establish common principles and guidelines ensuring the confidentiality of data used for the production of European statistics and the access to those confidential data with due account for technical developments and the requirements of users in a democratic society.
7.2. Confidentiality - data treatment
All age groups showing a total mortality of less than 4 cases are considered as confidential. Therefore, any 'confidential' age group 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). Since the Netherlands is not a small country no extra measures are taken.
For stillbirth and neonatal figures, no breakdown by parity is displayed to ensure confidentiality.
8.1. Release calendar
Provisional data is released on t + 6 months. Final data is released on t + 11 months.
8.2. Release calendar access
Not applicable.
8.3. Release policy - user access
Data is released on the website of Statistics Netherlands for the public, freely accessible.
Annual.
10.1. Dissemination format - News release
News releases online.
10.2. Dissemination format - Publications
On the website of Statistics Netherlands
10.3. Dissemination format - online database
Our cause of death data is published on our website in different tables:
Dutch tables: Opendata cbs website, Opendata cbs website dataset, Opendata cbs website table, Opendata cbs website, Opendata cbs website.
English tables: Deaths; cause of death (extensive list), age and sex, Deaths; underlying cause of death (shortlist), sex, age.
10.3.1. Data tables - consultations
| 2018 | 2019 | 2020 | 2021* | 2022 | 2023* | |
|---|---|---|---|---|---|---|
| Cause of death, most important causes of death (short list), age and gender | 9994 | 10771 | 11020 | 27108 | 15910 | 11906 |
| Causes of death, quarter and year of death | 874 | 788 | 877 | 32264 | 8776 | 3050 |
| Cause of death (expanded list), age and gender | 2820 | 2878 | 2898 | 16580 | 9453 | 7069 |
* new calculation method implemented, this table includes both visits to the Dutch and English tables.
10.4. Dissemination format - microdata access
Microdata send to Eurostat. Other researchers or research institutions through remote access accounts with restrictions.
10.5. Dissemination format - other
Information can be found here: CBS website - Causes of death statistics.
10.5.1. Metadata - consultations
Information on number of consultations are reported in internal documents.
10.6. Documentation on methodology
More information can be found here: CBS website - Causes of death statistics.
10.6.1. Metadata completeness - rate
All metadata is provided. More information can be found here: CBS website - Causes of death statistics.
10.7. Quality management - documentation
The quality of COD data is subject to the way in which the information on causes of death is reported and classified in each country. The Netherlands follow the standards and rules specified in the ICD.
However, national differences in interpretation and use of ICD rules exist and as a result important quality and comparability issues remain. The Netherlands is working towards further improving certification and coding procedures, for example by training doctors on certifying COD forms.
11.1. Quality assurance
The causes of death data are based on a regulation, which defines scope, definitions of variables and characteristics of the data.
11.2. Quality management - assessment
Statistics Netherlands is part of the IRIS core group and is working on keeping the quality on a high level.
12.1. Relevance - User Needs
The main users are Research Institutes, Universities, Public Government agencies, Private, Commission services and Business companies. The data needs of these users is collected regularly.
12.2. Relevance - User Satisfaction
Data is published with a good quality and on a timely basis.
12.3. Completeness
See subconcept 12.3.1
12.3.1. Data completeness - rate
1. For mandatory variables:
complete
2. For voluntary variables:
none
3. For additional variables:
- External CoD
complete
- Place of occurrence for external CoD
complete
- Activity for external CoD
none
13.1. Accuracy - overall
For people in the Dutch population register: All deceased persons registered in the Dutch population register, not all have death certificates for example when died abroad.
For people not registered in Dutch population register, but deceased in the Netherlands: only received death certificates.
13.2. Sampling error
Not applicable.
13.2.1. Sampling error - indicators
Not applicable.
13.3. Non-sampling error
Not applicable.
13.3.1. Coverage error
Not applicable.
13.3.1.1. Over-coverage - rate
Not applicable.
13.3.1.2. Common units - proportion
Not applicable. Data collection is from administrative sources.
13.3.2. Measurement error
Not applicable.
13.3.3. Non response error
Non response, as in not receiving a cause of death form for a Dutch citizen died in the Netherlands, is added to the data set with a cause of death as R99. Information on age, gender and region of death and recidence is known.
13.3.3.1. Unit non-response - rate
Non response, as in not receiving a cause of death form for a Dutch citizen died in the Netherlands, is added to the data set with a cause of death as R99. Statistics Netherlands does not receive around 3,5% of the cause of death forms for Dutch citizens who died in the Netherlands.
13.3.3.2. Item non-response - rate
Statistics Netherlands does not receive around 3,5% of the cause of death forms for Dutch citizens who died in the Netherlands, therefore 3,5% of the causes of death are unknown and set to the ICD10 code R99. All information on gender, age and residence is available, even for citizens without a cause of death form.
13.3.4. Processing error
Coding of the COD forms is primarily done with the Iris software. However, about 80% of the number of COD forms are still paper forms and have to be typed manually for further processing in Iris. Typing errors are kept to minimum by controlling the typed data.
13.3.5. Model assumption error
Not applicable.
14.1. Timeliness
Statistics Netherlands sents final data for the year N at N+24 months.
14.1.1. Time lag - first result
Not applicable.
14.1.2. Time lag - final result
Not applicable.
14.2. Punctuality
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.
14.2.1. Punctuality - delivery and publication
| Reference year | Time between the end of the reference year and the delivery of final data to Eurostat |
|---|---|
| 2015 | 18 |
| 2016 | 24 |
| 2017 | 13 |
| 2018 | 13 |
| 2019 | 12 |
| 2020 | 14 |
| 2021 | 13 |
| 2022 | 13 |
| 2023 | 16 |
15.1. Comparability - geographical
There is a complete comparability of the different regions of the Netherlands.
The process of collecting, coding and transmission is the same for all the regions in the Netherlands.
15.1.1. Asymmetry for mirror flow statistics - coefficient
Not applicable.
15.2. Comparability - over time
The comparability of the data over time is checked before dissemination.
15.2.1. Length of comparable time series
Time series on causes of death for the Netherlands on ICD10 start in 1996. A break in the series can be found in 2013, because Iris was implemented in 2013.
15.3. Coherence - cross domain
A check is done (on a daily basis) between the death records (the data provided by demography) and the processed death certificates.
There is a minor discrepency of 2% caused by not received death certificates, excluding residents who died abroad. If we include residents who died abroad the discrepency is about 3.5% of the death certificates.
15.3.1. Coherence - sub annual and annual statistics
Not applicable, only annual data are available.
15.3.2. Coherence - National Accounts
Not applicable.
15.4. Coherence - internal
For people in the Dutch population register: All deceased persons registered in the Dutch population register, but not all have death certificates for example when deceased abroad.
The cost and burden of the data collection is reduced by using validation and dissemination IT tools.
17.1. Data revision - policy
The dates of both the provisional data and the final data are published.
17.2. Data revision - practice
There is no systematic revision of previous year data.
17.2.1. Data revision - average size
Not applicable.
18.1. Source data
Death certificates
18.2. Frequency of data collection
On a daily basis
18.3. Data collection
Data are collected by the collection of death certificates filled out by physicians, these certificates are sent to Statistics Netherlands either as a physical certificate our via secure e-mail. The physical certificates are scannend and loaded into a software pogramme were the written text is transferred to typed text which can by translated into ICD-10 codes. About 50% of the certificates are coded automatically by IRIS-software, the other half is coded manually.
18.3.1. Certification
Table on certification (Percentage)
In 2013 we started (partly) coding with IRIS, due to which we didn't query any death certificate.
| Year |
All doctors (certifiers) trained in the certification | All doctors (certifiers - pathologists or others doctors) trained in the post-mortem examination (autopsies)* | Certificates filled by persons who attended a course on certification or post-mortem examination | Death certificates that are queried (only queries related to medical part of the death certificate should be included) | Replies received for queries sent | Deaths where the underlying cause is changed as a result of the query | Death certificates with incorrect sequence |
|---|---|---|---|---|---|---|---|
| 2011 | Unknown | Unknown | Unknown | not available | not available | not available | not available |
| 2012 | Unknown | Unknown | Unknown | 1% | 89% | 69% | Unknown |
| 2013 | Unknown | Unknown | Unknown | 0% | 0% | 0% | 0% |
| 2014 | Unknown | * | Unknown | ~1% | Majority responded | Unknown | Unknown |
| 2015 | Unknown | * | Unknown | ~1% | Majority responded | Unknown | Unknown |
| 2016 | Unknown | * | Unknown | ~1% | Majority responded | Unknown | Unknown |
| 2017 | Unknown | * | Unknown | ~1% | Majority responded | Unknown | Unknown |
| 2018 | Unknown | * | Unknown | ~1% | Majority responded | Unknown | Unknown |
| 2019 | Unknown | * | Unknown | ~1% | Majority responded | Unknown | Unknown |
| 2020 | unknown | * | Unknown | ~1% | Majority responded | Unknown | Unknown |
| 2021 | Unknown | * | Unknown | 0%** | not available | Unknown | Unknown |
| 2022 | Unknown | * | Unknown | 3.5% | Majority responded | Unknown | Unknown |
| 2023 | Unknown | * | Unkown | ~1% | Majority responded | Unkown | Unknown |
*All pathologists are trained in post-mortem examinitions, including autopsies, all certfiers are trained in the external examination of the dead body.
** Due to working from home no queries could be sent
18.3.2. Automated Coding
| Data year | Use of any form of automated coding | System used (IRIS, MICAR, ACME, STYX, MIKADO, others) |
|---|---|---|
| 1990 | No | |
| 1991 | No | |
| 1992 | No | |
| 1993 | No | |
| 1994 | No | |
| 1995 | No | |
| 1996 | No | |
| 1997 | No | |
| 1998 | No | |
| 1999 | No | |
| 2000 | No | |
| 2001 | No | |
| 2002 | No | |
| 2003 | No | |
| 2004 | No | |
| 2005 | No | |
| 2006 | No | |
| 2007 | No | |
| 2008 | No | |
| 2009 | No | |
| 2010 | No | |
| 2011 | No | |
| 2012 | No | |
| 2013 | Yes | partly Iris, partly manual |
| 2014 | Yes | partly Iris, partly manual |
| 2015 | Yes | partly Iris, partly manual |
| 2016 | Yes | partly Iris, partly manual |
| 2017 | Yes | partly Iris, partly manual |
| 2018 | Yes | partly Iris, partly manual |
| 2019 | Yes | partly Iris, partly manual |
| 2020 | Yes | partly Iris, partly manual |
| 2021 | Yes | partly Iris, partly manual |
| 2022 | Yes | partly Iris, partly manual |
| 2023 | Yes | partly Iris, partly manual |
18.3.3. Underlying cause of death
| Data year | Only manual selection of underlying cause | Manual with ACME decision tables (if yes, version of ACME) | ACS utilising ACME decision tables (if yes, version of ACME) | Own system (ACS without ACME) | Comments |
|---|---|---|---|---|---|
| 2011 | Yes | We are working at automated coding | |||
| 2012 | Yes | We are working at automated coding | |||
| 2013 | No | yes, Iris 4.2.0. MMDS2013 | MMDS2013 | From 2013 we are coding automatic with Iris, but not all records are coded completely final with Iris | |
| 2014 | No | yes, Iris 4.2.0, MMDS2014 | MMDS2014 | ||
| 2015 | No | yes, Iris 4.4.1, MMDS2015 | MMDS2015 | ||
| 2016 | No | yes, Iris 4.4.1, MMDS2016 | MMDS2016 | ||
| 2017 | No | yes, Iris 4.4.1, MMDS2017 | MMDS2017 | ||
| 2018 | No | yes, Iris 5.5.0, MMDS2018 | MMDS2018 | ||
| 2019 | No | yes, Iris 5.6.0, MMDS2019 | MMDS2019 | ||
| 2020 | No | yes, Iris 5.6.0, MMDS2020 | MMDS2020 | ||
| 2021 | No | yes, Iris 5.6.0, MMDS2021 | MMDS2021 | ||
| 2022 | No | yes, Iris 5.6.0, MMDS2021 | MMDS2021 | ||
| 2023 | No | yes, Iris 5.6.0, MMDS2021 | MMDS2021 |
18.3.4. Availability of multiple cause
| Data year | Information stored in the national CoD database, UC (Underlying cause) or MC (Multiple cause) |
|---|---|
| 2011 | UC + MC |
| 2012 | UC + MC |
| 2013 | UC + MC |
| 2014 | UC + MC |
| 2015 | UC + MC |
| 2016 | UC + MC |
| 2017 | UC + MC |
| 2018 | UC + MC |
| 2019 | UC + MC |
| 2020 | UC + MC |
| 2021 | UC + MC |
| 2022 | UC + MC |
| 2023 | UC + MC |
18.3.5. Stillbirths and Neonatal certificates
There are no different death certificates for neonates or stillbirhts. However for stillbirths data from the mothers of the stillbirths are recorded on stillbirth cards with the population register.
18.4. Data validation
The Dutch population register is used to validate the number of deaths.
Also checks are performed on: certain diseases which are gender specific and gender, perinatal death and age, and other diseases which are mostly seen in the eldery and age.
18.4.1. Coding
Description of coding procedure (central level, distributed among other bodies, etc.):
Central level
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):
Crosstabulations are done on gender specific conditions (specific for a gender), perinatal deaths and age, maternal deaths, and age specific conditions (conditions which are mostly seen in the eldery).
Description of the measures taken in order to solve detected errors:
Re-code the death certificate and manual checks.
Coding performed by a certifier:
Not Available, Dutch certifiers do not code.
Estimation of the percentage of autopsy from which information is available for coding:
Not Available
Description of double coding exercises and rate of codification errors for underlying cause of death:
Not Available
18.4.2. Unspecified CoD code
ICD codes for the underlying cause (% of the Total)
| Year | Unspecified CoD (for ICD10: R00-R99 codes, for ICD9: 780-790 codes) | Unknown CoD (for ICD10: R98-R99 codes, for ICD9: 799.9, 798.9, 798.2 codes) | Deaths due to senility (for ICD10: R54 code, for ICD9: 797 code) | Deaths due to exposure to unspecified factor (for ICD10: X59 code, ICD9: 928.9 code) |
|---|---|---|---|---|
| 2011 | 3,7 | 1,7 | 1,0 | 0,5 |
| 2012 | 3,9 | 1,7 | 1,1 | 0,5 |
| 2013 | 3,9 | 2,0 | 1,0 | 0,5 |
| 2014 | 4,0 | 2,0 | 1,0 | 0,4 |
| 2015 | 3,7 | 1,7 | 1,1 | 0,4 |
| 2016 | 4,1 | 1,9 | 1,2 | 0,4 |
| 2017 | 4,1 | 2,0 | 1,1 | 0,4 |
| 2018 | 4,2 | 2,0 | 1,2 | 0,4 |
| 2019 | 4,5 | 2,2 | 1,1 | 0,3 |
| 2020 | 4,5 | 2,4 | 1,1 | 0,4 |
| 2021 | 5,4 | 3,2 | 1,1 | 0,4 |
| 2022 | 6,1 | 3,7 | 1,1 | 0,5 |
| 2023 | 6,5 | 4,2 | 1,1 | 0,5 |
18.4.3. Unknown country or region
Unknown country/region (%) for residents and non-residents who died in the country
| Year | Residents | Non-residents | |||
|---|---|---|---|---|---|
| Unknown residency (NUTS2) | Unknown occurrence (NUTS2) | Unknown residency (country) | Unknown residency (NUTS2) | Unknown occurrence (NUTS2) | |
| 2011 | 0 | 0 | 100% | ||
| 2012 | 0 | 0 | 100% | ||
| 2013 | 0 | 0 | 100% | ||
| 2014 | 0 | 0 | 100% | ||
| 2015 | 0 | 0 | 100% | ||
| 2016 | 0 | 0 | 100% | ||
| 2017 | 0 | 0 | 100% | ||
| 2018 | 0 | 0 | 42,7% | 100% | 0% |
| 2019 | 0 | 0 | 40,3% | 100% | 0% |
| 2020 | 0 | 0 | 47,7% | 100% | 0% |
| 2021 | 0 | 0 | 24,5% | 100% | 0% |
| 2022 | 0 | 0 | 42,1% | 100% | 0% |
| 2023 | 0 | 0 | 24,5% | 100% | 0% |
18.4.4. Validation of the coverage
The Dutch registers are considered complete.
18.5. Data compilation
Not applicable.
18.5.1. Imputation - rate
Not applicable.
18.6. Adjustment
Not applicable.
18.6.1. Seasonal adjustment
Not applicable.
None.
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 medical certification of death is an obligation in the Netherlands. Statistcs Netherlands codes the information provided in the medical certificate of cause of death into ICD codes according to the rules specified in the ICD.
23 April 2025
Concepts and definitions are described in the Commission regulation (EU) No 328/2011 in articles 2 and 3.
The statistical unit is the deceased person and the stillborns.
Residents, non-residents and stillbirhts.
All people registrered in Dutch population register, died in the Netherlands as well as abroad. And all other persons deceased in the Netherlands but not registered in Dutch population register.
Data refer to the calendar year 2023 (i.e. all deaths occurring during the year 2023).
For people in the Dutch population register: All deceased persons registered in the Dutch population register, not all have death certificates for example when died abroad.
For people not registered in Dutch population register, but deceased in the Netherlands: only received death certificates.
The data are provided in absolute numbers only.
Not applicable.
Death certificates
Annual.
Statistics Netherlands sents final data for the year N at N+24 months.
There is a complete comparability of the different regions of the Netherlands.
The process of collecting, coding and transmission is the same for all the regions in the Netherlands.
The comparability of the data over time is checked before dissemination.
