Assessment of errors in death certification and mortality patterns and trends among medical patients at Korle Bu Teaching Hospital, 2019-2023

Objectives: This study audited the Medical Certification of Cause of Death (MCCD) forms issued at Korle-Bu Teaching Hospital, assessing their accuracy, completeness, and consistency while analysing trends in mortality causes. Design: Retrospective review of completed MCCD forms. Setting: Korle-Bu Teaching Hospital, Department of Medicine. Participants: All duplicate MCCD forms issued between January 1^st, 2019, and December 31^st, 2023, were included. Interventions: No intervention Main outcome measures: Frequency of major and minor errors in completing the MCCD forms and leading causes of death in the department. Results: Of 4,544 MCCD forms audited, 4,460 (98.17%) contained errors. Major errors were observed in 4,028 (88.64%) forms; the commonest being incorrect reporting of the underlying cause of death (3,483; 76.65%). Minor errors were nearly universal (99.82%), with omission of the full address of the deceased (4,530; 99.69%) being most frequent. Over half of the recorded deaths each year were attributable to non-communicable diseases (NCDs), with cardiovascular-related conditions being the leading cause of death. Conclusions: There was a high prevalence of errors in MCCD forms, highlighting the need for regular training of healthcare professionals to improve accuracy in death certification. Additionally, the high burden of NCD-related deaths emphasises the need to address modifiable risk factors, strengthen health systems, and foster multisectoral collaboration to mitigate the growing NCD epidemic.