Non-reporting: An additional challenge for injury prevention

We all know that injury prevention research and intervention is frequently at the beck and call of funding by governments and policy-makers, industry and research councils. Funding decisions are often informed by statistics, such as prevalence and incidence, therefore it is vital that injury prevention researchers and practitioners have access to – and report – the most complete statistics possible.

Related to this point, today I came across an interesting article by Neate, Bugeja, Jelinek, Spooner, Ding and Ranson in the Medical Journal of Australia titled “Non-reporting of reportable deaths to the coroner: When in doubt, report”. In Victoria, Australia, “deaths that appear unexpected, unnatural or violent or have resulted directly or indirectly from an accident or injury, or are related to a medical procedure” must be reported to the Coroner. Doctors must submit a death certificate for deaths arising from all other causes to the Registry of Births, Deaths and Marriages (BDM). However, in recent years BDM staff noted that death certificates had been inappropriately issued for cases that should have been referred to the coroner, therefore the researchers sought to examine these cases, including the accuracy of the death certificate between 1 July 2003 and 30 June 2011.

Focusing upon the period between 1 July 2010 and 30 June 2011, 656 deaths were referred from BDM to the Coroner. Of these, subsequent investigation revealed 48.8% of the deaths were reportable, nearly all of which resulted from trauma (190 fracture-related deaths; 107 head injury-related deaths). Non-trauma related causes included choking, poisoning, and transport-related. Nearly 56% were women, 44.7% were aged 80-89 years, and 45.6% of death certificates required major changes to correct inaccuracies.

The Authors propose a number of reasons for such a high inaccuracy rate, ranging from difficulty in understanding reporting obligations to the erroneous belief that deaths are only reportable if they are deemed to be ‘suspicious’. Of particular interest to injury prevention researchers and practitioners, as noted by the Authors

“Detailed death investigations can provide vital information….regarding not only the cause of death, but also potentially preventable aspects of the death. This information is important to the health system and the wider community as it underpins patient management, risk management systems and disease prevention strategies.” 


Injury prevention

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