Czech Statistical Office

Demographic Statistics Unit

Czech Statistical Office
Na padesátém 81
100 82 Praha 10
Czech Republic

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 obtained/derived from the medical part of death certificates. The Czech Statistical Office codes the information about causes of death into ICD codes according to the rules specified in the ICD. The underlying cause of death is selected by automated coding system (IRIS).

Data are broken down by sex, age, underlying cause of death, residency of deceased person and country of occurrence. Stillbirths and neonatal deaths are additionally broken down by age of mother.

Annual national data are provided in absolute numbers and at regional level NUTS 2.

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

There is a difference between the regulation's definition and national statistical concept for stillbirth, see point 3.4.2.

Registered population is aplied.

a) National definition used for stillbirths

The national legislation currently does not contain general definitions of a live birth and a stillbirth

Existing legal regulation, the Act No 372/2011 Sb, on Health Services, as amended, defines only a foetus after abortion, which is a foetus, which after the complete expulsion or extraction from its mother shows none of the signs of life and at the same time its birth weight is lower than 500 g and provided that the weight cannot be measured, if the pregnancy lasted less than 22 weeks.

On that base, the definitions of live birth and stillbirth along with all cases of abortions are stated in the guidelines for filling in the “Death certificate (Report on examination of the deceased person)” (in the Decree No 297/2012 Sb, on the Death certificate (Report on examination of the deceased person) as amended), namely for the needs of filling in of the Death certificate. The stillbirth is defined there as the foetus, which after the complete expulsion or extraction from its mother shows none of the signs of life and at the same time its birth weight is 500 g and over and provided that the weight cannot be measured, if the pregnancy lasted 22 weeks and over, and provided that the length of the pregnancy cannot be measured, if the crown-heel length is 25 cm and over.

The national number of stillbirths is adjusted to being in compliance with the regulation's definition. Spontaneous abortions that meet the definition of stillbirth are added.

 b) Characteristics collected

Gestational age, weight and crown-heel lenght.

The statistical unit is the deceased person and stillbirth. The reporting unit is the certifier-physician.

Registered population = the citizens of the Czech Republic and foreigners with permanent residence in the Czech Republic, third-country nationals with temporary residence in the territory of the Czech Republic based on a long-term visa (over 90 days) or a permanent residence permit, nationals of the EU Member States, Norway, Switzerland, Iceland, Liechtenstein and their dependants with notified temporary residence in the territory of the Czech Republic and foreigners with valid asylum status in the Czech Republic. The counts of deaths of Czech citizens with the permanent residence in the Czech Republic that occurred abroad and were registered in the Czech Republic are also included.

Neonates of non-resident mothers aren’t included since they are considered as non-residents.

The non-resident's deaths aren’t included in national statistics.

The residents of Czech citizenship deceased abroad are included in the national statistics if their death is registered by the Czech authorities. Code R99 as the underlying cause of death is usually assigned to these deaths because a cause of death is not known in most cases.

Czech Republic - national and NUTS 2 level.

Data requested according to the Implementing Regulation No. 328/2011 are available since 2011.

National data on residents are available since 1919.

Not applicable.

The data are sent in absolute numbers.

Data refer to the calendar year (i.e. all deaths occurring during the year).

The State Statistical Service Act  defines the framework of Population Statistics in the Czech Republic.
The 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 European Union level.
Within the context of this framework Regulation, the 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.

The State Statistical Service Act No 89/1995;

The agreement on mutual provision of statistical information and confidential statistical data for the purposes of ensuring the performance of the State Statistical Service is signed between the CZSO and the Institute of Health Information and Statistics of the CR (IHIS CR).

Policy follows §16, §17, §18 of the State Statistical Service Act and a Personal Data Protection Act

§18 of the State Statistical Service Act

Deaths by the abbreviated List of Causes of Death in the Czech republic and its Regions and Districts - 2013–2022: 29 June

Demographic Yearbook of Regions of the Czech Republic: 15 August

Deaths by Cause, Sex and Age in the Czech Republic and its Regions: 15 September

Demographic Yearbook of the Czech Republic: 2 October

Statistical Yearbook of the Czech Republic: 27 November

Czech Demographic Handbook: 23 November

https://www.czso.cz/csu/czso/population-publication

§17 and §18 of the State Statistical Service Act

Since 2013, annual.

 Not applicable.

All demographic data outputs/publications are accessible on the CZSO website: https://www.czso.cz/csu/czso/population-publication

Public database: https://vdb.czso.cz/vdbvo2/faces/en/index.jsf?page=statistiky#katalog=30845

The first release of data in June.

Data from cause of death statistics are published as a monothematic publication called “Deaths by Cause, Sex and Age in the Czech Republic and its Regions” and as well as the part of all yearbooks with demographic subject (Statistical yearbook, Demographic yearbook issue for national level and issues for several regional levels). The number of on-line consultationsonly for the whole publications is available in the CZSO; thus only consultations of the monothematic publication are here provided.

Not applicable.

Not applicable.

Information not available.

https://www.czso.cz/csu/czso/population-change-methodology

Information not available.

The standards and rules specified in the ICD are followed. 

The cause of death data are based on the Regulation, which defines scope, definitions of variables according to them data are broken down.

There has not been any quality assessment in the year 2022.

Information not available.

Information not available.

Deaths:

Deaths of Czech nationals with registered residence in the Czech Republic that took place abroad are included into statistics, if they were registered by the Czech authorities (the bereaved requested the registration). Unidentified dead bodies are not statistically processed.

Stillbirths:

Stillbirths to parents with Czech citizenship and registered residence in the Czech Republic (at least one parent) that took place abroad are included into statistics, if their birth was registered by the Czech authorities (if the parents of the child requested the registration). Foundlings and children from undisclosed deliveries (according to the relevant law), i.e. births without information about the mother, are not statistically processed.

All registered spontaneous abortions that meet the regulation definition of stillbirth are included. Sex is not collected in case of abortions.

1. For mandatory variables:

 100%

All mandatory variables required by the Implementing Regulation No. 328/2011 are transmitted to the European Commission.

The underlying cause of death is usually unknown for residents deceased abroad, code R99 is assigned.

2. For voluntary variables:

 The sex is unknown for the part of stillbirths, i.e. for those which are derived from the dataset of spontaneous abortions (they are classified as spontaneous abortions according to the national definition on foetus after abortion) that meet the regulation's definition of stillbirth (see 3.4.2)

The underlying cause of death is unknown for stillbirths, the coding R99 is used for statistics transmitted to Eurosat according to the Implementing Regulation No 328/2011.

The NUTS2 region of occurrence is unknown for residents deceased abroad. This variable is unknown for the part of stillbirths too, i.e. for those which are derived from the dataset of spontaneous abortions (they are classified as spontaneous abortions according to the national definition on foetus after abortion) that meet the regulation’s definition of stillbirth (see 3.4.2)

The NUTS2 region of residence is unknown for non-residents who died in the territory of the Czech Republic

 The parity is known only for the part of stillbirths, i.e. for those which are derived from the dataset of spontaneous abortions (they are classified as spontaneous abortions according to the national definition on foetus after abortion) that meet the regulation definition of stillbirth (see 3.4.2).

3. For additional variables:

• External CoD
It’s the same situation as the underlying cause of death: External CoD is unknown for stillbirths and usually unknown for residents deceased abroad; code R99 is assigned.
• Place of occurrence for external CoD
It’s the same situation as the underlying cause of death: unknown for stillbirths and usually unknown for residents deceased abroad; because the external CoD is not identified, the place of occurrence remains blank.
• Activity for external CoD
The activity for external CoD is required only for dataset COD_GEN and there is the same situation as the underlying cause of death: usually unknown for residents deceased abroad; because the external CoD is not identified, the activity remains blank.

The control of continuity of serial numbers of records on deaths in the national registry, which are collected as well in statistical reports, ensures the completeness of counts of deaths and stillbirths (according to the national definition of stillbirth).

Deaths: If a statistical report on death is not linked with a death certificate with information on causes of death of the same person, code R99 as the underlying cause of death is assigned.

Stillbirths: In case of stillbirths coming from national statistics on stillbirths, the parity is not available.

The Institute of Health Information and Statistics of the CR that collects data on abortions and provide them to the CZSO is responsible for the accuracy of data on spontaneous abortions that meet the regulation's definition of stillbirth.

Not applicable.

Not applicable.

Not applicable.

Sources of coverage completeness:

The control of continuity of serial numbers records of death in the national registry, which are collected in statistical reports as well, ensures the completeness of the total number of deaths and stillbirths (according to national definition).

Deaths:

Unidentified dead bodies are not statistically processed (cca 0.03% of total).

If a statistical report on death is received after the deadline of the annual data processing, it is included in the next year data. If a corpse is found and the date of death is specified as in the previous year(s), then this case is included into statistics of the currently processed year. The share of late registered deaths was 0.03% on average.

Stillbirths:

Foundlings and children from undisclosed deliveries (according to the relevant law), i.e. births without information about a mother, are not statistically processed.

Not applicable. Data collection is based on/comes from administrative sources.

Not applicable.

Deaths:

This information is available only for non-response of cause(s) of death.

The code R99 as the underlying cause of death is assigned to deaths of Czech nationals that took place abroad or when the information on causes of death information is missing (i.e. death certificate without causes of death, missing death certificate with the causes of death information or death certificate not linked with a statistical report on the death).

Deaths: The share of missing information on cause(s) of death (%)

*applicable since 2013

Not applicable.

Not applicable.

Not applicable.

According to the Implementing Regulation (EC) No. 328/2011, each year Member State provide the Commission (Eurostat) with data at national and regional level and related metadata for the reference year within 24 months (in connection with the gentleman agreement within 18 months) from the end of the reference year.

National data

* postponed due to the change in the data collection system

** postponed due to the bug in templates of death certificate in some medical devices

Not applicable.

Not applicable.

Data are delivered to the Eurostat on time.

*The first version of dataset have been delivered 21. 12. 2012, but the second have been according to the Implementing Regulation No. 328/2011.

Data are fully comparable.

Not applicable.

Causes of deaths:

Data requested according to the Implementing Regulation No. 328/2011: available since 2011; derogation on the country of occurrence in 2011.

National data on residents: available since 1919

Breaks in series:

1. in connection with the World War II:

• data from period 1938-1940 relate only to the territory of the Protectorate Bohemia and Moravia,
• data from period 1941-1944 relate only to the territory of the Protectorate Bohemia and Moravia and exclude the Germans,
• data from period 1945-1946 exclude the Germans;

       on the contrary demographic statistics data on deaths in 1937-1946 were adjusted to the territory in 1937 and to the whole population.

2. due to implementation of actual version of ICD and its updates:

   ICD-3: 1919
   ICD-4: 1931
   ICD-5: 1941
   ICD-6: 1949
   ICD-7: 1958
   ICD-8: 1968
   ICD-9: 1979
   ICD-10: 1994
     2009 ICD-10 updates: 2009
     2010 ICD-10 updates: 2011
     2012 ICD-10 updates: 2012
     2013 ICD-10 updates: 2013
     2018 ICD-10 updates: 2018

     2021 ICD-10 updates: 2021

3. due to changes in data processing:

 2007: ACME decision tables were introduced into coding procedures
 2011: implementation of IRIS automated coding software
 2013: introduction of a new death certificate with four lines in part I for certification of causes of death

Stillbirths:

Data requested according to the Implementing Regulation No. 328/2011:

available since 2011; adjusted to being in compliance with the regulation's definition; fully comparable over time.

Data according to national definition:

 available since 1919; breaks as a consequence of the change in definition in 1949, 1953, 1965, 1988 and 2012

Follows from the above (15.2).

Data published by the CZSO or provided to other international organizations include only events of registered residents (occurred in the territory of the CR or in case of Czech nationals residents also occured abroad) i.e. they do not include data on non-residents.

Deaths:

The share of missing information on the cause of death, owing to not linking with a statistical report on death, or missing cause of the death information for deaths that took place abroad reached 1.1% (from the total number of resident's and non-resident's deaths) in 2022. Deaths of residents with the Czech citizenship who died abroad comprise 43% of this share.

Stillbirths:

Stillbirths according to the national definition are collected in the framework of statistics on births. The national definition of stillbirth is partly different from the definition stated in the Implementing Regulation No. 328/2011 (see point 3.4.2). The national definition of stillbirths is applied on data provided to Eurostat according to the Regulation No. 1260/2013.

Other data sources of stillbirths are available in the CR (death certificates, the register of newborns), but they are not processed/managed by the CZSO and their coverage is incomplete.

Not applicable for deaths by cause of death, since only annual data are available. Stillbirths in national concept are published quarterly as preliminary.

Not applicable.

National changes in definitions and classifications are usually implemented at the beginning of the reference year. Data sent at the Commission (Regulation No. 328/2011) request are prepared according to definitions and classifications stated in the Regulation.

The electronic version of reports/certificates is developed for reduction of the cost and burden, but not used by every reporting units.

Generally not applicable except for territorial changes; then data are backwards (for at least 10 previous years) recalculated.

There is no systematic data revision of previous years except for territorial changes.

Not applicable.

Causes of death:

Statistical reports on death provided to the CZSO by registry offices linked with information on causes of death from death certificates provided to CZSO by the Institute of Health Information and Statistics of the CR, which collects death certificates with CoD information.

Stillbirths:

Statistical reports on birth provided to the CZSO by registry offices for national statistics on (still)births.

Spontaneous abortions:

Annual data set of individual records provided to the CZSO by the Institute of Health Information and Statistics of the CR.

Data are collected on a monthly base.

The ICD-10 and its rules have been used.

Table on certification (Percentage)

*The share from sent data (residents and non-residents together)

** Change of the queries system from year 2013; queries are sent to the IHIS CR instead of to Registry offices.

***The share from DC that are queried.

The exact data about number of certificates filled by persons who attended a course on certification or post-mortem examination are not available from years 2014 – the table contains expert estimation.

There is an increase of queried death certificates (and received replies) because of the revision process of selected deaths in 2020 associated with covid-19 by the panel of experts and experts from IHIS CR.

a) Stillbirths

Two data sources are used to compile data (stillbirths for national statistics are not collected via death certificate, and there is no special DC for perinatal deaths):

• Statistical reports on birth, from which the national statistics on stillbirths is compiled.
• Reports on abortion and ectopic pregnancy termination provide information on spontaneous abortions that meet the definition of stillbirth according to the Regulation No 328/2011.

 b) Neonates

Data are collected via the same statistical report on death as for all other deaths.

The control of continuity of serial numbers of record on death and births (for stillbirths) in the national registry, which are collected in statistical reports as well, ensures the completeness.

Deaths:

The completeness is checked also thanks to the use of two data sources for CoD statistics compilation, which are linked.

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

Coding is performed centrally.

Coders transcript ICD-10 codes from the death certificate to the data processing system, if the code corresponds with a text diagnosis. If they are not corresponding, codes are changed according to the text diagnosis (except the fourth digit of the ICD-10 code stated by the physician is more specific than text). Coders are not medically educated, but they are regularly and ad-hoc trained by experts from the CZSO and IHIS CR. 

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):

Each code is validated on age, sex, ill-defined causes, trivial causes of death and rare diseases. Before sending queries correctness of coding by the supervising coder is checked. Underlying cause of death is selected on the basis of ICD-10 rules automatically in IRIS; rejects are coded manually according to the ACME/MUSE decision tables. In case of external cause of death, the main injury is also selected on the basis of ICD-10 rules. Data are validated in IRIS and via the national validation tool. The IHIS CR is responsible for validation tools.

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

Validation tools (IRIS, national validation tool) include instructions on how to solve a problem. Selected cases of neoplasms of uncertain or unknown behaviour, cases of tuberculosis and the most problematic cases are consulted and solved together with the experts from the IHIS CR, who consult medical experts if needed.

Coders are trained on how to avoid the most frequent errors almost each year.

Coding is carried out at a central level.

Coding performed by a certifier:

Yes, but is not obligatory. The physician fills in usually both text diagnoses and ICD codes in the death certificate.

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

*The share from sent data (residents and non-residents together)

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

Done only as checks before sending queries; not statistically evaluated.

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

*The share from sent data (residents and non-residents together)

**Including missing information on cause of death (death occured abroad, missing death certificate with causes of death information)

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

*Without death of residents of the Czech citizenship occured abroad.

** Useing other administrative sources for determination the place of residency.

The control of continuity of serial numbers of records on death in the national registry, which are collected in statistical reports as well, ensures the completeness of deaths and stillbirths (in compliance with national definition).

Deaths:

Since 2013, the completeness is checked also thanks to the use of two data sources for CoD statistics compilation, which are linked.

Causes of death:

Underlying cause of death is selected on the basis of ICD-10 rules automatically in IRIS; rejects are coded manually according to the ACME decision tables. Data are validated in IRIS and by the national validation tool. In case of external causes of death, the main injury is also selected on the basis of ICD-10 rules.

Stillbirth:

The number of stillbirths has to be adjusted, because the national definition differs from the regulation's definition. The total count of stillbirths comprises of stillbirths from national statistics on stillbirths and spontaneous abortions, which meet the regulation definition of stillbirth (fulfill at least one criterion of stillbirth i.e. the birth weight, the gestation duration or the birth length respectively).

In case of stillbirths coming from national statistics on stillbirths, the parity is not available. Since 2014, only live birth-order of live births is collected.

Not applicable.

No adjustments

Not applicable.

None.