Reference metadata describe statistical concepts and methodologies used for the collection and generation of data. They provide information on data quality and, since they are strongly content-oriented, assist users in interpreting the data. Reference metadata, unlike structural metadata, can be decoupled from the data.
Data on causes of death (COD) provide information on mortality patterns and form a major element of public health information. The objective is to produce and provide statistical information on the causes of death by sex, age, place of residence. COD data are derived from Medical death certificates and Medical perinatal death certificates. The medical certification of death is an obligation in Lithuania. 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". The causes of death are classified according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). Since April 2011 ICD-10-AM (Australian Modification) is using in Lithuania on a national level, but for Eurostat and the WHO, code conversion is made to be in-line with the International Statistical Classification of Diseases and Related Health Problems, tenth edition (ICD-10). Annual national data at national level are publicated in absolute numbers, crude death rates and standartised death rates.
3.2. Classification system
See table 3.2 "Classification and updates applied by years" in annex "COD_CODNSI_A_LT_2024_Annex".
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
Usual residence means the place where a person normally spends the daily period of rest, regardless of temporary absences for purposes of recreation, holidays, visits to friends and relatives, business, medical treatment or religious pilgrimage.
The following persons alone shall be considered to be usual residents of a specific geographical area:
those who have lived in their place of usual residence for a continuous period of at least 12 months before the reference time;
those who arrived in their place of usual residence during the 12 months before the reference time with the intention of staying there for at least one year.
Resident population means all persons having their usual residence in the Republic of Lithuania at the reference time.
3.4.2. Stillbirth definition and characteristics collected
Stillbirth means foetal death, namely death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy. Death is indicated by the fact that after such separation from its mother the foetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles.
Stillbirths having weight from 500 g and gestational age from 22 completed weeks are included.
Birth weight, gestational age, and crown-heel length are collected.
3.5. Statistical unit
The statistical unit are the deceased persons and the stillborns, respectively.
3.6. Statistical population
The survey covers the deaths of usual residents of the Republic of Lithuania and the stillbirths born in Lithuania whose parents (or at least one of them) are usual residents of Lithuania or their origins are unknown.
3.6.1. Neonates of non-resident mothers
The survey covers the deaths neonates of non-resident mothers whose father is a permanent resident of Lithuania or their origins are unknown.
3.6.2. Non-residents
In the database of The State Register of Death Cases and Their Causes are collected cases of death of persons who died in the territory of the Republic of Lithuania and citizens of the Republic of Lithuania who died abroad and their causes. Lithuanian causes of death statistics cover only all deaths of the residents of Lithuania.
3.6.3. Residents dying abroad
Data causes of deaths covers residents who died abroad.
3.7. Reference area
Entire territory of the Republic of Lithuania.
3.8. Coverage - Time
Since 1994.
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
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.
Commission Regulation (EU) No 328/2011 of 5 April implementing Regulation (EC) No 1338/2008 of the European Parliament and of the Council on Community statistics on public health and health and safety at work, as regards statistics on causes of death.
Data from Lithuanian Statistics Causes of Death are shared with the World Health Organisation (WHO) after a formal request. Some data are shared with OECD too.
7.1. Confidentiality - policy
Regulation (EC) No 223/2009 of the European Parliament and of the Council of 11 March 2009 on European statistics and repealing Regulation (EC, Euratom) No 1101/2008 of the European Parliament and of the Council on the transmission of data subject to statistical confidentiality to the Statistical Office of the European Communities, Council Regulation (EC) No 322/97 on Community Statistics, and Council Decision 89/382/EEC, Euratom establishing a Committee on the Statistical Programs of the European Communities;
In Lithuania statistical information is published on the Institue of Hygiene Internet Site and on the Official Statistics Portal on the Database of Indicators (Population and social statistics -> Population -> Mortality->Deaths by cause of death) (data available in Lithuanian and English).
Annual.
10.1. Dissemination format - News release
Regular news releases on Official Statistics Portal and Institute of Hygiene and irregular press releases.
Regulation (EC) No 1338/2008 of the European Parliament and of the Council of 16 December 2008 on Community statistics on public health and health and safety at work; Commission Regulation (EU) No 328/2011 of 5 April implementing Regulation (EC) No 1338/2008 of the European Parliament and the Council on Community statistics on public health and health and safety at work, as regards statistics on causes of death; Methodological information of The State Register of Death Cases and Their Causes (only in Lithuanian); Medical death certificate forms are based on the template provided by the World Health Organization (WHO); According to the WHO guidelines and the Eurostat recommendations were prepared the methodological manual of certification of cause of death „Instruction of filling medical death certificate“ (only in Lithuanian); The cause of death is classified according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). Since April 2011 ICD-10-AM (Australian Modification) is using in Lithuania on a national level, but for Eurostat and the WHO, code conversion is made to be in-line with the International Statistical Classification of Diseases and Related Health Problems, tenth edition (ICD-10); Underlying causes of death are defined according to International Statistical Classification of Diseases and Related Health Problems rules – ICD-10 Vol.2.
10.6.1. Metadata completeness - rate
1.0
10.7. Quality management - documentation
The quality of statistical information and its production process is ensured by the provisions of the European Statistics Code of Practice. Underlying causes of death are defined following the International Statistical Classification of Diseases and Related Health Problems rules – ICD-10 Vol. 2 and the recommended WHO's updates are applied.
Quality of death statistics is evaluated using international indicators of quality of death statistics.
12.1. Relevance - User Needs
The main users of statistical information are State and municipal authorities and agencies, international organizations, the media, research and business communities.
All indicators established by the legislation are published and available. All mandatory data for Lithuania is provided in full detail and in timely manner.
12.3.1. Data completeness - rate
1. For mandatory variables:
All mandatory variables required by the Commission regulation n°328/2011 are transmitted to the European Commission.
2. For voluntary variables:
The State Register of Death Cases and Their Causes are not able to provide age of mother variables concerning stillbirth data. Age of mother variable falls into the regulation scope of the Law on Legal Protection of Personal Data of Republic of Lithuania.
3. For additional variables:
External CoD.
are transmitted to the European Commission;
Place of occurrence for external CoD.
are transmitted to the European Commission;
Activity for external CoD.
are transmitted to the European Commission.
13.1. Accuracy - overall
Statistical information is compiled on the basis of administrative data, so the overall accuracy of the data is high.
13.2. Sampling error
A continuous statistical survey based on administrative data is carried out, no sample is taken.
13.2.1. Sampling error - indicators
Not applicable.
13.3. Non-sampling error
Statistical survey is conducted based on administrative data. Accuracy of statistical data depends on the quality of the administrative sources.
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
Errors due to non-response are not calculated, all necessary data for calculations are obtained from administrative sources.
13.3.3.1. Unit non-response - rate
All data used for calculations are obtained from administrative sources, the non-response rate of a statistical unit is not calculated.
13.3.3.2. Item non-response - rate
Item non-response rate is considered to be equal to 0 per cent, all necessary item values are obtained from administrative sources.
13.3.4. Processing error
Not applicable.
13.3.5. Model assumption error
Not applicable.
14.1. Timeliness
Final micro data are provided to Eurostat for the year T (“T + 18 months“). National provisional annual statistical data is published at the middle of May, final statistical data – at the beginning of August after the end of the reference year. Provisional monthly statistical information of a reference month is published after 45 days from the end of the reference month.
See table 14.1 "Timeliness" in annex "COD_CODNSI_A_LT_2024_Annex".
See table 14.2.1. "Punctuality - delivery and publication" in annex "COD_CODNSI_A_LT_2024_Annex".
15.1. Comparability - geographical
Statistical information is comparable among the European Union Member States.
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. It could be that in few categories of causes of death, for which not all EU Member States reported data, the EU average is not be strictly comparable over time due to different composition of countries.
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.
15.2.1. Length of comparable time series
Since 1994.
15.3. Coherence - cross domain
Indicator values are reconciled with the statistical survey on the determination of the number and composition of permanent residents.
15.3.1. Coherence - sub annual and annual statistics
Not applicable.
15.3.2. Coherence - National Accounts
Not applicable.
15.4. Coherence - internal
Monthly and annual statistical indicators are coherent.
Administrative data are used. No response burden is caused.
Users are informed about planned revisions in advance in the Calendar of Planned Revisions of Health Statistical Information. As legal acts change, revisions of statistical indicators are carried out in case of significant errors. Users are immediately informed about their results and changes made.
17.2.1. Data revision - average size
The difference between annual provisional and final data is insignificant: usually absolute numbers do not change, rates could be slightly different because of provisional and final number of population is used.
18.1. Source data
The statistics on causes of death are based on the information provided on medical death certificates. Medical death certificate form based on the template provided by the World Health Organization (WHO). The medical certification of death is an obligation.
All deaths of residents and non-residents are collected. Database of State Register of Death Cases and Their Causes is the main data source of causes of death statistics. Lithuanian causes of death statistics covers all deaths of the residents of Lithuania.
18.2. Frequency of data collection
Monthly, annual.
18.3. Data collection
Data are collected by the collection of death certificates filled out by physicians. Medical death certificates (paper form) once a month are forwarded to the Institute of Hygiene. Electronic medical death certificates are collected from the e-health system. Specialists manually code multiple causes of deaths and select code of the underlying cause of death. IRIS is used to check the selection of the underlying cause.
18.3.1. Certification
See table 18.3.1. "Certification" in annex "COD_CODNSI_A_LT_2024_Annex".
18.3.2. Automated Coding
See table 18.3.2. "Automated Coding" in annex "COD_CODNSI_A_LT_2024_Annex".
18.3.3. Underlying cause of death
See table 18.3.3. "Underlying cause of death" in annex "COD_CODNSI_A_LT_2024_Annex".
18.3.4. Availability of multiple cause
See table 18.3.4. "Availability of multiple cause" in annex "COD_CODNSI_A_LT_2024_Annex".
18.3.5. Stillbirths and Neonatal certificates
For stillbirths and neonates aged less than 7 days, a Perinatal death certificate is used. For neonates, 7-27 days, used a Medical death certificate.
18.4. Data validation
Data validation with several institutions - Register of Residents and State Data Agency.
18.4.1. Coding
Description of coding procedure (central level, distributed among other bodies, etc.):
Coding is carried out at a central level. The specialists of State Register of Death Cases and Their Causes manually code multiple causes of deaths and select code of the underlying cause of death which is defined as “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”. Causes of death are classified according to the International Statistical Classification of Diseases and Related Health Problems (ICD-10-AM, Australian Modification) on a national level, but for Eurostat and WHO converted codes are provided to be in-line with ICD-10. Underlying causes of death are defined in accordance with the International Statistical Classification of Diseases and Related Health Problems rules – ICD-10 Vol. 2. IRIS used to check the selection of the underlying cause.
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 State Register of Death Cases and Their Causes database contains an automatic quality of data transcription assurance system which checks cause of death against the gender and age of the deceased.
Description of the measures taken in order to solve detected errors:
Visual control of register data, logic control during data entry process, computerised control after data entry.
Coding performed by a certifier:
Physicians issue medical death certificates, they do not perform coding of multiple causes of death.
Estimation of the percentage of autopsy from which information is available for coding:
Forensic medical experts and pathologist performed an 13.2 percent of autopsies of all deceased per year 2024. The underlying cause of death is determined after autopsy.
Description of double coding exercises and rate of codification errors for underlying cause of death:
No double coding exercises performed.
18.4.2. Unspecified CoD code
See table 18.4.2. "Unspecified CoD code" in annex "COD_CODNSI_A_LT_2024_Annex".
18.4.3. Unknown country or region
See table 18.4.3. "Unknown country or region" in annex "COD_CODNSI_A_LT_2024_Annex".
18.4.4. Validation of the coverage
From Resident Register The State Register of Death Cases and their Causes receive the deceased name, surname, sex, nationality, date of death, place of death, place of residence. From the State Data Agency The State Register of Death Cases and Their Causes receive „resident or non-resident“ attribute for a deceased person.
Data on causes of death (COD) provide information on mortality patterns and form a major element of public health information. The objective is to produce and provide statistical information on the causes of death by sex, age, place of residence. COD data are derived from Medical death certificates and Medical perinatal death certificates. The medical certification of death is an obligation in Lithuania. 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". The causes of death are classified according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). Since April 2011 ICD-10-AM (Australian Modification) is using in Lithuania on a national level, but for Eurostat and the WHO, code conversion is made to be in-line with the International Statistical Classification of Diseases and Related Health Problems, tenth edition (ICD-10). Annual national data at national level are publicated in absolute numbers, crude death rates and standartised death rates.
17 June 2026
Concepts and definitions are described in the Commission regulation (EU) No 328/2011 in articles 2 and 3.
The statistical unit are the deceased persons and the stillborns, respectively.
The survey covers the deaths of usual residents of the Republic of Lithuania and the stillbirths born in Lithuania whose parents (or at least one of them) are usual residents of Lithuania or their origins are unknown.
Entire territory of the Republic of Lithuania.
Data refer to the calendar year (i.e. all deaths occurring during the year).
Statistical information is compiled on the basis of administrative data, so the overall accuracy of the data is high.
The statistics on causes of death are based on the information provided on medical death certificates. Medical death certificate form based on the template provided by the World Health Organization (WHO). The medical certification of death is an obligation.
All deaths of residents and non-residents are collected. Database of State Register of Death Cases and Their Causes is the main data source of causes of death statistics. Lithuanian causes of death statistics covers all deaths of the residents of Lithuania.
Annual.
Final micro data are provided to Eurostat for the year T (“T + 18 months“). National provisional annual statistical data is published at the middle of May, final statistical data – at the beginning of August after the end of the reference year. Provisional monthly statistical information of a reference month is published after 45 days from the end of the reference month.
See table 14.1 "Timeliness" in annex "COD_CODNSI_A_LT_2024_Annex".
Statistical information is comparable among the European Union Member States.
The comparability of the data over time is checked before dissemination. It could be that in few categories of causes of death, for which not all EU Member States reported data, the EU average is not be strictly comparable over time due to different composition of countries.
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.
