Citation

Vennemann MMT, Berger K, Richter D, Baune BT. Dtsch Arztebl Ausg A 2006; 103(18): 1222-1226.

Copyright

(Copyright © 2006, Deutscher Ärzte-Verlag)

DOI

unavailable

PMID

unavailable

Abstract

INTRODUCTION: Suicide statistics represent an important health indicator for any country, but suicide rates are often underestimated. Suicide rates in Germany for the year 2002 varied considerably among communities in Germany's largest state of North Rhine-Westphalia. The degree of underreporting and the reason for the marked differences in suicide rates is poorly understood.

METHODS: We examined all death certificates for a documented suicide in five communities for the years 2002 and 2003 and compared these findings with the official suicide rates reported by the state health statistics.

RESULTS: Between 1998 and 2002 the state's suicide rates decreased from 9.41 to 8.44 per 100,000, but the rate of deaths of unknown cause increased from 22.57 to 27.12, We found 44 documented but unassessed suicides among all death certificates of the five communities examined. This yields an overall underreporting of 11 per cent of all suicides. All available data sources were only used in two of five local health departments, despite being actually or potentially available in all offices.

CONCLUSION: Failure to consider all available information led to incomplete suicide assessment in two of five local health departments. Death certificate management at a local level contributed to variations in local suicide rates. Since change in suicide rates is often used as an outcome measure of community based intervention programs, state-wide standardization in the management of death certificates is needed.

Language: de

Keywords

Prevention; human; suicide; Suicide; Autopsy; Germany; mortality; Cause of death; article; controlled study; statistical analysis; health program; patient care; information processing; medical documentation; outcomes research; death certificate; standardization; mandatory reporting; Health report