Objective: To evaluate the efficacy of seminars on the international criteria for medical certification of the causes of death.
Design: A pre-test/post-test evaluation, with no reference group.
Setting: A primary care health district in Andalusia, Spain.
Participants: The 44 doctors in this district.
Intervention: Training seminars and evaluation of the filling-in of the Statistical Decease Forms (SDF) during the six months after the seminar.
Measurements and main results: Four quality indicators were used to assess doctors' filling-in of the SDFs, which contain the international criteria for certification of the causes of death, six months before and six months after the holding of the seminars. The results were then compared. In 11.4% the legibility of the hand-writing improved; and in 16.5% there was less confusion between the mechanism of death and the cause. The clinical sequence of causes reported and the indicator of more than one diagnosis per line did not vary significantly.
Conclusions: Although the seminars on international norms of certification are necessary in order to improve the standard of mortality statistics, a change in the ways of certifying causes of death requires ongoing commitment to the training of certifying doctors.