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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | Istat - Italian National Statistical Institute |
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1.2. Contact organisation unit | SWC - Division for integrated system for health, social assistance and welfare |
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1.5. Contact mail address | Viale Liegi, 13 00198 Rome Italy |
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2.1. Metadata last certified | 18/12/2023 | ||
2.2. Metadata last posted | 18/12/2023 | ||
2.3. Metadata last update | 18/12/2023 |
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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 Italy. The information provided in the medical certificate of cause of death is coded into the International Classification of Diseases (ICD) codes according to the rules specified in the ICD. |
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3.2. Classification system | ||||||||||||||||||||||||||||||||||||
Eurostat's CoD statistics build on standards set out by the World Health Organisation (WHO) in the International Classification of Diseases (ICD). The regional breakdown is based on the Nomenclature of Territorial Units for Statistics (NUTS 2).
Classification and updates applied by years
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3.3. Coverage - sector | ||||||||||||||||||||||||||||||||||||
Public Health, Causes of death |
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3.4. Statistical concepts and definitions | ||||||||||||||||||||||||||||||||||||
Concepts and definitions are described in the Commission regulation (EU) No 328/2011 in articles 2 and 3. |
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3.4.1. National definition used for usual residency | ||||||||||||||||||||||||||||||||||||
Usual residency refers to the Italian legal residency registered at Civil Registry and it is the place where a person normally spends the daily period of rest, regardless of temporary absences |
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3.4.2. Stillbirth definition and characteristics collected | ||||||||||||||||||||||||||||||||||||
In Italy there is a definition applied in the survey on spontaneous abortion: stillbirths are fetal deaths with a gestational age of more than 180 days. The characteristics collected are: gestational age, weight, crown-heel |
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3.5. Statistical unit | ||||||||||||||||||||||||||||||||||||
The statistical units are the deceased persons and the stillborns, respectively. |
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3.6. Statistical population | ||||||||||||||||||||||||||||||||||||
All deaths and stillbirths occurring in Italy, distinguishing residents and non-residents. |
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3.6.1. Neonates of non-resident mothers | ||||||||||||||||||||||||||||||||||||
Neonates of non-resident mothers are not considered residents as the residence of newborns is the residence of the mother. |
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3.6.2. Non-residents | ||||||||||||||||||||||||||||||||||||
Non-residents are included in national statistics if they die in our country. |
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3.6.3. Residents dying abroad | ||||||||||||||||||||||||||||||||||||
Residents dying abroad are not included as our national statistics refer only to deaths that occurred in the country. |
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3.7. Reference area | ||||||||||||||||||||||||||||||||||||
The statistical data on causes of death refers to Italy. Region of occurrence and residence (Nuts2) are indicated. |
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3.8. Coverage - Time | ||||||||||||||||||||||||||||||||||||
Italian data are available from 1994 onwards.
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3.9. Base period | ||||||||||||||||||||||||||||||||||||
Not applicable. |
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The unit is number. |
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Data refer to the calendar year (i.e. all deaths occurring during the year). |
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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 the 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 the reference year 2011. |
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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 Regulation No 328/2011. |
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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. Information on Istat confidentiality policy is available on the Istat website: https://www.istat.it/en/methods-and-tools/methods-and-it-tools/analyse |
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7.2. Confidentiality - data treatment | |||
All cells corresponding to marginal totals by cause with a mortality of fewer than 3 cases are considered “confidential”. To ensure statistical confidentiality we apply a different treatment depending on the type of output.
Regarding the data warehouse, we designed tables not at risk of disclosure (in some cases we aggregated them at a territorial level).
With regard to the aggregated file by cause for research purposes, each 'confidential' cell is collapsed by making a grouping for all causes.
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8.1. Release calendar | |||
Annually, about 24 months after the end of the reference period. |
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8.2. Release calendar access | |||
Not applicable. |
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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, the 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. At the national level, aggregated data are disseminated for free to all users in electronic format (website, Istat data warehouse), at the same time. |
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Annual. |
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10.1. Dissemination format - News release | |||
At the Eurostat level, news releases online. At the National level, it is not applicable. |
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10.2. Dissemination format - Publications | |||
Causes of death data are disseminated in many different publications "multi-source". Among the most relevant there are:
"Italian Statistical Yearbook" (https://www.istat.it/it/archivio/277962) "BES. Benessere Equo Sostenibile" (https://www.istat.it/it/archivio/282920) Annexes: BES. Benessere Equo Sostenibile Italian Statistical Yearbook Noi Italia |
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10.3. Dissemination format - online database | |||
Please consult free data online: http://ec.europa.eu/eurostat/data/database Health For All: http://www.istat.it/it/archivio/14562 Istat.Data: https://esploradati.istat.it/databrowser/#/en/dw/categories/IT1,Z0810HEA,1.0/HEA_DEATH Annexes: Istat.Data I.Stat Health For All Eurostat db |
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10.3.1. Data tables - consultations | |||
Not available. |
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10.4. Dissemination format - microdata access | |||
According to the national laws, techniques have been adopted to protect the confidentiality of the microdata. Given the sensitiveness of data, microdata access is limited to the projects included in the National Statistical Program (PSN) approved by law. |
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10.5. Dissemination format - other | |||
For the reference year 2020, a press release was released: https://www.istat.it/it/archivio/284853 For the reference year 2020, the provisional data were released: https://www.istat.it/it/files//2022/10/decessi-per-causa-principali-risultati-Nota-metodoloigica-2sem2020-1-1.pdf For the reference year 2020, only concerning March and April, a report was released: https://www.istat.it/it/files//2021/04/Report-Cause-di-Morte_21_04_2021.pdf Only for data of the reference years 2011-2013, a release was disseminated: https://www.istat.it/it/archivio/196880 A relevant publication is also the following: "La mortalità dei bambini ieri e oggi: l’Italia post-unitaria a confronto con i Paesi in via di sviluppo" http://www.istat.it/it/archivio/40505 |
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10.5.1. Metadata - consultations | |||
Not available. |
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10.6. Documentation on methodology | |||
Process documents are available here: http://siqual.istat.it/SIQual/lang.do?language=UK |
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10.6.1. Metadata completeness - rate | |||
All the concepts are provided. |
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10.7. Quality management - documentation | |||
The official quality documentation on causes of death statistics is available on the Istat official quality documentation system (SIQual) : http://siqual.istat.it/SIQual/visualizza.do?id=5000131 |
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11.1. Quality assurance | |||
Since the 90s Istat adopted a systematic approach to ensure quality in both statistical information and service to the community: https://www.istat.it/en/organisation-and-activity/institutional-activities/quality-commitment |
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11.2. Quality management - assessment | |||
In 2015 an audit procedure to assess the system of statistics on causes of death has been performed. The overall assessment was positive, the aims of the system are clear and well defined, and they are shown on a wiki page. The audit showed that there are no issues related to the coverage and the list of references of the survey. Furthermore, any attempt to reduce the statistical burden was performed. Regarding IT, the validated data are systematically stored on an Oracle DB, and they are adequately protected following the standards of the Institute. The data released on the web are accompanied by links to SIQual, the Istat official quality documentation system. |
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12.1. Relevance - User Needs | |||
Main users are public national and local government, public research institutes and private researchers. Data are mainly used to support the decisions about public policies on health and to study the mortality (trend, risk factors, etc) Sometimes users ask for more detailed data (e.g. nuts3 level, microdata), but generally, these requests cannot be met for confidentiality reasons. |
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12.2. Relevance - User Satisfaction | |||
The views and opinions of the users are not regularly collected but during the meeting, for the arrangement of the National Statistical Program (PSN), the Committee of Statistical Information Users (CUIS) is consulted to highlight the possible weaknesses of data. In general terms, the users resulted satisfied. |
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12.3. Completeness | |||
All data requested are sent and disseminated on Eurostat's website. |
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12.3.1. Data completeness - rate | |||
1. For mandatory variables: 100% 2. For voluntary variables: 76% (19/25) 3. For additional variables:
It is provided for general and neonatal deaths, not for stillbirths
It is not provided
It is not provided |
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13.1. Accuracy - overall | |||
As the data collection is total population-based, the sampling error is not applicable. Many efforts are spent to detect and to obtain the missing models by the non-respondent municipalities, reaching a coverage level of about 100%. An editing and imputation procedure is applied to data to check and correct the measurement errors and item non-responses. Significant investments (tools to support encoding, training coders, etc.) are continuously made to improve the quality of causes of death coding. |
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13.2. Sampling error | |||
Not applicable. Data collection is from administrative sources. |
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13.2.1. Sampling error - indicators | |||
Not applicable. |
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13.3. Non-sampling error | |||
see 13.1 |
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13.3.1. Coverage error | |||
The coverage error is about 0,3% |
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13.3.1.1. Over-coverage - rate | |||
not applicable |
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13.3.1.2. Common units - proportion | |||
Not applicable. Data collection is from administrative sources. |
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13.3.2. Measurement error | |||
Not applicable |
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13.3.3. Non response error | |||
Not applicable |
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13.3.3.1. Unit non-response - rate | |||
Not applicable |
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13.3.3.2. Item non-response - rate | |||
Not applicable |
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13.3.4. Processing error | |||
Not applicable |
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13.3.5. Model assumption error | |||
Not applicable. |
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14.1. Timeliness | ||||||||||||||||||||||||
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14.1.1. Time lag - first result | ||||||||||||||||||||||||
not applicable |
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14.1.2. Time lag - final result | ||||||||||||||||||||||||
24 months |
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14.2. Punctuality | ||||||||||||||||||||||||
From data collection with the reference year 2011 onwards, Istat meets the deadline of the Implementing Regulation (EC) No. 328/2011, Article 4. COD 2019 data arrived in early 2022, because in 2021 many problems slowed down the data production process. COD 2020 data arrived in early 2023, because in 2021 and 2022 many problems slowed down the data production process. |
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14.2.1. Punctuality - delivery and publication | ||||||||||||||||||||||||
The scheduled date for delivery/release of the data is respected |
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15.1. Comparability - geographical | |||
The data are geographically comparable because all data processing is managed centrally by Istat. Moreover, geographical coverage is complete and missing events are of negligible order. |
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15.1.1. Asymmetry for mirror flow statistics - coefficient | |||
Not applicable. |
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15.2. Comparability - over time | |||
Due to the fact that in 2003 the tenth revision of the ICD has been adopted the data between 1994-2002 and starting from 2003 could not be always comparable. Moreover time series for data on stillbirths starts in 2011 and no information on previous data is available. |
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15.2.1. Length of comparable time series | |||
General mortality: since 2003 |
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15.3. Coherence - cross domain | |||
Two different data sources for collecting mortality data in Italy are carried out by the National Institute of Statistics (Istat):
1) “Deleted to death from population registers” (Demographic Statistics or DS)
2) “Causes of death” (CoD).
The DS survey refers to cancellation due to death from the Population register of all residents in Italy, including those who died abroad. CoD statistics instead refer to all deaths that occurred in Italy (for both residents and non-residents).
The discrepancies found between DS and CoD data are primarily ascribed to the different data sources: acquisition of an administrative archive cancellation for the DS data versus a data collection of death certificates completed by physicians for the CoD data and to the different population that these two different data sources belong to, actually the residents dying outside the country are collected only by DS.
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15.3.1. Coherence - sub annual and annual statistics | |||
Not applicable, only annual data are available. |
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15.3.2. Coherence - National Accounts | |||
Not applicable. |
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15.4. Coherence - internal | |||
Italian data on causes of death are internally consistent. |
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The main costs concern the recording and coding phases. Nevertheless increasing the use of IT tools allowed to reduce costs. |
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17.1. Data revision - policy | |||
Not applicable. |
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17.2. Data revision - practice | |||
There is no systematic revision of the previous year's data. Data are occasionally revised, e.g. if the "NUTS" changes. |
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17.2.1. Data revision - average size | |||
Not applicable. |
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18.1. Source data | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
For each death, a death certificate is filled in by a physician. He must indicate "all diseases, morbid or traumatic conditions that led or contributed to death, and the circumstances of the accident or violence that provoked these traumatisms" in the health section of the certificate, hereby also reporting other relevant information linked to the death. Once the physician has filled in the health section, the form is sent to the pertinent municipality. The registrar must complete the certificate by indicating the socio-demographic data of the deceased. In particular, other than the dates of birth and death this information concerns the place of birth and residence, marital status, educational level, profession, branch of economic activity, citizenship and individual code of the deceased. If a death has occurred during the first year of life, the form is slightly different and, as regards the demographic section, the requested information mainly refers to the condition of the parents. Having been filled out in duplicate, the form follows two different paths: one copy is sent to the ASL (where the death occurred), whereas the other copy, before being sent to Istat, is sent to the Prefectures. |
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18.2. Frequency of data collection | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Annual. |
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18.3. Data collection | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The Italian statistics on causes of death are produced by a centralized system of coding and data processing.
Causes of death are coded by an automated coding system (ACS), that requires alphanumerical registration of the health section of the death certificate. Only causes rejected by this system are manually coded. Since the reference year 2003 also data on multiple causes are coded.
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18.3.1. Certification | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Not applicable because we do not have any statistics on certification training or post-mortem exam courses attended by certifiers. We also do not handle any post-mortem queries. Table on certification (Percentage)
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18.3.2. Automated Coding | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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18.3.3. Underlying cause of death | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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18.3.4. Availability of multiple cause | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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18.3.5. Stillbirths and Neonatal certificates | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
a) Stillbirths the source of data is the Birth Delivery Certificate for which the Ministry of Health is responsible (Decree of Ministry of Health 349/2001). This information source collects data about births, stillbirths and congenital anomalies at birth, irrespective of the duration of pregnancy.
b) Neonates Istat has a different death certificate for neonatal and infant deaths (all deaths under 1 year of age) https://www.istat.it/ws/fascicoloSidi/1080/Scheda%20di%20morte%20-%20Modello%20D.4%20Bis.pdf |
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18.4. Data validation | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
An editing and imputation procedure is applied to check and correct the measurement errors and item non-responses. The procedure is based on both deterministic (health and socio-demographic data) and probabilistic approaches (socio-demographic data), to input incorrect and missing data. |
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18.4.1. Coding | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Description of coding procedure (central level, distributed among other bodies, etc.): The coding is performed at a central level, using the automated coding system Iris. The percentage of rejects of Iris is about 20%. Rejected certificates are manually revised by trained coders.
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): Inconsistencies between the cause of death and other information on the death certificate (age, sex, manner of death) are detected with online alerts during coding, so the coders can check the original death certificate and correct it. At the end of the year, a consistency check is also run for the detection of inconsistencies.
Description of the measures taken in order to solve detected errors: Errors detected are corrected manually by expert coders.
Coding performed by a certifier: Certifiers do not perform coding in Italy
Estimation of the percentage of autopsy from which information is available for coding: Not applicable
Description of double coding exercises and rate of codification errors for the underlying cause of death: Not applicable |
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18.4.2. Unspecified CoD code | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
ICD codes for the underlying cause (% of the Total)
* The increase compared to previous years is due to the adoption of ICD10 version 2019 (according to which certificates with cardiac arrest as UC must be classified as deaths due to unknown cause R99). |
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18.4.3. Unknown country or region | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Unknown country/region (%) for residents and non-residents who died in the country
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18.4.4. Validation of the coverage | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
We use external sources such as the data of demographic events of the civil registry. |
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18.5. Data compilation | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The imputation procedures are based on both deterministic (health and socio-demographic data) and probabilistic approaches (socio-demographic data), to input incorrect and missing data. |
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18.5.1. Imputation - rate | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Age: 9.0% |
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18.6. Adjustment | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Not applicable |
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18.6.1. Seasonal adjustment | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Not applicable. |
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None. |
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