1.1. Contact organisation
The Danish Health Data Authority
1.2. Contact organisation unit
Analytics, Statistics and Economics
1.3. Contact name
Confidential because of GDPR
1.4. Contact person function
Confidential because of GDPR
1.5. Contact mail address
AMTR@sundhedsdata.dk
1.6. Contact email address
Confidential because of GDPR
1.7. Contact phone number
Confidential because of GDPR
1.8. Contact fax number
2.1. Metadata last certified
16 January 2025
2.2. Metadata last posted
21 January 2025
2.3. Metadata last update
9 January 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 information provided in the medical certificate of cause of death is mapped to the International Statistical Classification of Diseases and Related Health Problems (ICD).
3.2. Classification system
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
| Data year | ICD classification used (ICD-9, ICD-10) (3 or 4 chars) | For ICD-10: updates used |
| 2011 | ICD-10 | |
| 2012 | ICD-10 | |
| 2013 | ICD-10 | |
| 2014 | ICD-10 | |
| 2015 | ICD-10 | |
| 2016 | ICD-10 | |
| 2017 | ICD-10 | |
| 2018 | ICD-10 | |
| 2019 | ICD-10 | |
| 2020 | ICD-10 | |
| 2021 | ICD-10 | |
| 2022 | ICD-10 |
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
Persons with a valid Social Security number residing in Denmark.
3.4.2. Stillbirth definition and characteristics collected
Stillbirth is defined as all births after gestination of 22 weeks (>=22+0), where the child shows no signs of life at birth.
3.5. Statistical unit
The statistical units are the deceased persons and the stillborns, respectively.
3.6. Statistical population
Residence in Denmark at the time of death.
3.6.1. Neonates of non-resident mothers
No, neonatals of non-resident mothers are not considered residents.
3.6.2. Non-residents
Non-residents are not included in the National statistics.
3.6.3. Residents dying abroad
No, residents dying abroad are not included in national statistics.
3.7. Reference area
National.
3.8. Coverage - Time
Time series for most EU-28 countries and EFTA are available from 1994 onwards (Belgium, Germany: 1992, Ireland: 1993). For some countries data are only available from 1995 (Bulgaria), 1996 (Latvia and Slovakia), 1999 (Cyprus, Poland and Romania) or 2010 (Liechtenstein) 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 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.
3.9. Base period
Not applicable.
The unit is number.
Data refer to the calendar year (i.e. all deaths occurring during the year).
6.1. Institutional Mandate - legal acts and other agreements
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.
6.2. Institutional Mandate - data sharing
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' 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.
8.1. Release calendar
December the following year.
8.2. Release calendar access
Please find information at this website (Esundhed Udgivelseskalender).
8.3. Release policy - user access
In line with the Community legal framework and the European Statistics Code of Practice Eurostat disseminates European statistics on Eurostat's website (see item 10 - 'Accessibility and clarity') respecting professional independence and in an objective, professional and transparent manner in which all users are treated equitably. The detailed arrangements are governed by the Eurostat protocol on impartial access to Eurostat data for users.
Annual.
10.1. Dissemination format - News release
News releases on-line.
10.2. Dissemination format - Publications
In our publication "Dødsårsagsregister", and on our website.
10.3. Dissemination format - online database
Please find information at this website (Esundhed doedsaarsagsregisteret).
10.3.1. Data tables - consultations
Please consult free data on-line or refer to contact details.
10.4. Dissemination format - microdata access
Yes.
10.5. Dissemination format - other
Not applicable
10.5.1. Metadata - consultations
No
10.6. Documentation on methodology
Please find information at this website (Esundhed Dokumentation).
10.6.1. Metadata completeness - rate
Documents for COD are available in CIRCABC, Causes of Death section.
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 (i.e. national certification and coding procedures). In general, all countries follow the standards and rules specified in the ICD, and the overall procedures for the collection of COD data are relatively homogenous between European countries (medical certification of cause of death, use of ICD).
However, national differences in interpretation and use of ICD rules exist and as a result important quality and comparability issues remain. Based on the report "Comparability and Quality Improvement of the European Causes of Death Statistics" countries work towards further improving certification and coding procedures.
Ongoing work is reported to Eurostat's Working Group "Public Health Statistics" (documents available on circabc).
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
A quality assessment of Eurostat's COD statistics was organised in May and June 2008. In that framework, a questionnaire was sent to Eurostat's partners (data providers) for COD statistics and a user survey was set up on Eurostat's website, for which 25 partners and 34 users answered. A questionnaire was also filled in by responsible people of COD statistics in Eurostat.
12.1. Relevance - User Needs
Based on the 34 answers received from the web survey, the main users are Research Institutes, Universities, Public Government agencies, Private, Commission services and Business companies. On these 34 answers, Eurostat data on Causes of Death are "essential", "important", or "used for background information" for 25 respondents.
Asking about the availability of needed data in the Eurostat production, users are divided in two equivalent part: 12 answered that they do not need statistics on the field not currently available from Eurostat and 13 answered that they need, giving information about defects and lacks of the Eurostat data.
12.2. Relevance - User Satisfaction
Users were asked to assess each of the classical elements that characterise the quality of statistics.
Respondents generally give high scores to the different dimensions of data quality and to the supporting service that is perceived as "Good or Very Good" by the users (14 out of 21 respondents expressing opinions about this). The overall quality, comprising both data quality and supporting service, is perceived as "Good" or "Very good" by 16 out of 24 respondents to those questions.
Among different data quality dimensions, coherence and comparability receive the higher satisfaction. The less appreciated dimension is the completeness.
12.3. Completeness
Not available
12.3.1. Data completeness - rate
1. For mandatory variables:
100 percent.
2. For voluntary variables:
100 percent.
3. For additional variables:
- External CoD
Not available.
- Place of occurrence for external CoD
Not available.
- Activity for external CoD
Not available.
13.1. Accuracy - overall
The data for 2022 are based on 97 pct. of all incoming death certificates. In those cases were we didn't get the certificate electronically the cause of death is "unknown" in the data.
13.2. Sampling error
Not applicable. Data collection is from administrative sources.
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
Not applicable.
13.3.3.1. Unit non-response - rate
Not applicable.
13.3.3.2. Item non-response - rate
Not applicable.
13.3.4. Processing error
Not applicable.
13.3.5. Model assumption error
Not applicable.
14.1. Timeliness
| Year | Number of months between the end of the reference year and the publication at national level |
| 2011 | 12 |
| 2012 | 12 |
| 2013 | 12 |
| 2014 | 12 |
| 2015 | 12 |
| 2016 | 12 |
| 2017 | 12 |
| 2018 | 12 |
| 2019 | 12 |
| 2020 | 11 |
| 2021 | 11 |
| 2022 | 11 |
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 |
| 2011 | 24 |
| 2012 | 24 |
| 2013 | 24 |
| 2014 | 24 |
| 2015 | 24 |
| 2016 | 24 |
| 2017 | 28 |
| 2018 | 26 |
| 2019 | 24 |
| 2020 | 24 |
| 2021 | 24 |
| 2022 | 24 |
15.1. Comparability - geographical
There is a small difference in missing certificates across regions. However coding and transmission are equal for all regions.
| Region |
Missing certificates (%) |
|---|---|
| Region Nordjylland | 3,74 |
| Region Midtjylland | 2,13 |
| Region Syddanmark | 2,61 |
| Hovedstaden | 3,28 |
| Sjælland | 3,28 |
15.1.1. Asymmetry for mirror flow statistics - coefficient
Not applicable.
15.2. Comparability - over time
Up until 2018 Denmark have included neonatal deaths where an abortion procedure was performed. These special cases results in a livebirth and therefore they were included in both the General and infant mortality statistics, they were recorded as neonatal deaths (NND).
As of 2019 these case have been removed from both datasets.
15.2.1. Length of comparable time series
From 2007 the repaorted death data were electronic.
15.3. Coherence - cross domain
The data is checked with the national demographic data called CPR-register. The discrepency in total deaths is denoted as Unknowns in the death cause registry.
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
The data source between neonates and the general mortality are different. However there should not be any inconsistencies.
The cost and burden of the data collection is reduced by using validation and dissemination IT tools.
17.1. Data revision - policy
Not applicable.
17.2. Data revision - practice
There is no systematic revision of previous year data. Data are occasionally revised, e.g. if the "NUTS" changes or if a country notifies Eurostat about any changes in the data.
17.2.1. Data revision - average size
Not applicable.
18.1. Source data
Our CoD database is based on the reported death certificates. In Denmark the death certificates are reported electronically. Almost 98 pct. of all page 2 certificates are reported electronically at the time when the annual statistics is published. Since it is possible to report certifcates afterwards, data for 2019 and before that will getting more complete over the years.
18.2. Frequency of data collection
Annual.
18.3. Data collection
Not applicable
18.3.1. Certification
Table on certification (Percentage)
| 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 | |
| 2020 | |
|||||||
| 2012 | 100 |
100 | 100 | |||||
| 2013 | 100 |
100 | 100 | |||||
| 2014 | 100 | 100 | 100 | |||||
| 2015 | 100 | 100 | 100 | |||||
| 2016 | 100 | 100 | 100 | |||||
| 2017 | 100 | 100 | 100 | |||||
| 2018 | 100 | 100 | 100 | |||||
| 2019 | 100 | 100 | 100 | |||||
| 2020 | 100 | 100 | 100 | |||||
| 2021 | 100 | 100 | 100 | |||||
| 2022 | 100 | 100 | 100 |
18.3.2. Automated Coding
| Data year | Use of any form of automated coding | System used (IRIS, MICAR, ACME, STYX, MIKADO, others) |
| 2011 | Yes |
Acme |
| 2012 | Yes | Acme |
| 2013 | Yes | Acme |
| 2014 | Yes | Acme |
| 2015 | Yes | Acme/Iris |
| 2016 | Yes | Acme/Iris |
| 2017 | Yes | Acme/Iris |
| 2018 | Yes | Acme/Iris |
| 2019 | Yes | Acme/Iris |
| 2020 | Yes | Acme/Iris |
| 2021 | Yes | Acme/Iris |
| 2022 | Yes | Acme/Iris |
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 | ACME 2007 | ||||
| 2012 | ACME 2011 | ||||
| 2013 | ACME 2012 | ||||
| 2014 | ACME 2012 | ||||
| 2015 | ACME/IRIS | ||||
| 2016 | ACME/IRIS | ||||
| 2017 | ACME/IRIS | ||||
| 2018 | ACME/IRIS | There is extend manual validation. For 2018 we use the ACME tables updated from the IRIS - group | |||
| 2019 | Acme/Iris | There is extend manual validation. For 2019 we use the ACME tables updated from the IRIS - group | |||
| 2020 | Acme/Iris | There is extend manual validation. For 2020 we use the ACME tables updated from the IRIS - group | |||
| 2021 | Acme/Iris | There is extend manual validation. For 2021 we use the ACME tables updated from the IRIS - group | |||
| 2022 | Acme/Iris | <There is extend manual validation. For 2022 we use the ACME tables updated from the IRIS - group |
18.3.4. Availability of multiple cause
| Data year | Information stored in the national CoD database, UC (Underlying cause) or MC (Multiple cause) |
| 2011 | MC |
| 2012 | MC |
| 2013 | MC |
| 2014 | MC |
| 2015 | MC |
| 2016 | MC |
| 2017 | MC |
| 2018 | MC |
| 2019 | MC |
| 2020 | MC |
| 2021 | MC |
| 2022 | MC |
18.3.5. Stillbirths and Neonatal certificates
There is no special death certificate for neonates and stillbirths.
18.4. Data validation
The national death registry is compared to the CPR registry.
18.4.1. Coding
Description of coding procedure (central level, distributed among other bodies, etc.):
Coding is done manually by employees of the responsible government agency.
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):
The IRIS algorithm evaluates all data for consistency with WHO guidelines and corrects where necessary. Certain of these corrections as well as select groups of causes are flagged for manual validation.
Description of the measures taken in order to solve detected errors:
Trained professionals evaluate the output of IRIS with supplementary information on the death certificates and contact the submitting doctors where necessary.
Coding performed by a certifier:
IRIS is an algorithm developed and maintained by Federal Institute for Drugs and Medical Devices (BfArM) in Cologne. This is based on up-to-date guidelines for coding with ICD10 as decided by WHO.
Estimation of the percentage of autopsy from which information is available for coding:
Autopsy findings can be written on any death certificate but the fields are not mandatory. The information in these fields is available for review but is text-based and thus not harmonized as quantifiable data points.
Description of double coding exercises and rate of codification errors for underlying cause of death:
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 | ||||
| 2012 | ||||
| 2013 | ||||
| 2014 | ||||
| 2015 | ||||
| 2016 | ||||
| 2017 | ||||
| 2018 | ||||
| 2019 | 7,6 | 5,1 | 2,1 | 0 |
| 2020 | 8,6 | 6,1 | 2,2 | 0 |
| 2021 | ||||
| 2022 |
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 | |||||
| 2012 | |||||
| 2013 | |||||
| 2014 | |||||
| 2015 | |||||
| 2016 | |||||
| 2017 | |||||
| 2018 | |||||
| 2019 | 0,0 | 5,7 | 18,1 | 98,3 | 40,7 |
| 2020 | 0,0 | 5,4 | 28,8 | 98,1 | 38,5 |
| 2021 | |||||
| 2022 | |||||
18.4.4. Validation of the coverage
Not applicable
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.
No further comments.
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).
9 January 2025
Concepts and definitions are described in the Commission regulation (EU) No 328/2011 in articles 2 and 3.
The statistical units are the deceased persons and the stillborns, respectively.
Residence in Denmark at the time of death.
National.
Data refer to the calendar year (i.e. all deaths occurring during the year).
The data for 2022 are based on 97 pct. of all incoming death certificates. In those cases were we didn't get the certificate electronically the cause of death is "unknown" in the data.
The unit is number.
Not applicable.
Our CoD database is based on the reported death certificates. In Denmark the death certificates are reported electronically. Almost 98 pct. of all page 2 certificates are reported electronically at the time when the annual statistics is published. Since it is possible to report certifcates afterwards, data for 2019 and before that will getting more complete over the years.
Annual.
| Year | Number of months between the end of the reference year and the publication at national level |
| 2011 | 12 |
| 2012 | 12 |
| 2013 | 12 |
| 2014 | 12 |
| 2015 | 12 |
| 2016 | 12 |
| 2017 | 12 |
| 2018 | 12 |
| 2019 | 12 |
| 2020 | 11 |
| 2021 | 11 |
| 2022 | 11 |
There is a small difference in missing certificates across regions. However coding and transmission are equal for all regions.
| Region |
Missing certificates (%) |
|---|---|
| Region Nordjylland | 3,74 |
| Region Midtjylland | 2,13 |
| Region Syddanmark | 2,61 |
| Hovedstaden | 3,28 |
| Sjælland | 3,28 |
Up until 2018 Denmark have included neonatal deaths where an abortion procedure was performed. These special cases results in a livebirth and therefore they were included in both the General and infant mortality statistics, they were recorded as neonatal deaths (NND).
As of 2019 these case have been removed from both datasets.
