Current state of cause of death determinations in Japan and the need to list the precise underlying cause of death.

IF 1.5 4区 医学 Q1 LAW
Ken Inoue, Shuntaro Abe, Tatsushige Fukunaga
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引用次数: 1

Abstract

When death is caused by a disease, the precise cause of the death must be determined to promote health and contribute to prevention efforts. The circumstances of death should also be clarified so that measures can be taken to prevent the recurrence. Statistics regarding the cause of death must be accurate, and such statistics are shaped by the determination of the cause of death. We examined the annual cause of death rankings and the mortality rate in Japan during the 25-year period 1993-2017. We identified improvements that are needed to provide more precision in the cause of death statistics, with a focus on variations in the rankings, and we describe the peculiar and vulnerable aspects of the Vital Statistics system in Japan; for example, at one time the national government advised physicians to not list "heart failure" as the terminal stage of a condition on a death certificate, and the "heart disease" mortality rate thus tended to decline in that period. The ranking of "heart disease" as a cause of death decreased, but its mortality rate subsequently increased again. In addition, the "pneumonia" mortality rate has remained high over the past few years, but it abruptly decreased in 2017, when "aspiration pneumonia" was separated as a cause from other pneumonias. The "senility" mortality rate has increased annually, and it is a leading cause of death. It is important that physicians understand the underlying causes of death and provide that without being influenced by the reporting customs of the times.

日本死因确定的现状以及列出确切潜在死因的必要性。
当疾病造成死亡时,必须确定死亡的确切原因,以促进健康并有助于预防工作。还应澄清死亡的情况,以便采取措施防止再次发生。关于死亡原因的统计必须准确,而这种统计是在确定死亡原因的基础上形成的。我们研究了1993-2017年25年间日本的年度死因排名和死亡率。我们确定了需要改进的地方,以提供更精确的死亡原因统计,重点是排名的变化,我们描述了日本生命统计系统的特殊和脆弱方面;例如,国家政府曾一度建议医生不要在死亡证明上将"心力衰竭"列为疾病的最后阶段,因此在此期间"心脏病"死亡率趋于下降。“心脏病”作为死亡原因的排名下降了,但其死亡率随后又上升了。此外,“肺炎”死亡率在过去几年一直居高不下,但在2017年“吸入性肺炎”从其他肺炎中分离出来后,死亡率突然下降。"老年人"死亡率每年都在增加,它是死亡的主要原因。重要的是,医生要了解潜在的死亡原因,并在不受当时报告习俗影响的情况下提供这些原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medicine, Science and the Law
Medicine, Science and the Law 医学-医学:法
CiteScore
2.90
自引率
6.70%
发文量
53
审稿时长
>12 weeks
期刊介绍: Medicine, Science and the Law is the official journal of the British Academy for Forensic Sciences (BAFS). It is a peer reviewed journal dedicated to advancing the knowledge of forensic science and medicine. The journal aims to inform its readers from a broad perspective and demonstrate the interrelated nature and scope of the forensic disciplines. Through a variety of authoritative research articles submitted from across the globe, it covers a range of topical medico-legal issues. The journal keeps its readers informed of developments and trends through reporting, discussing and debating current issues of importance in forensic practice.
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