Trends in Electronic Death Certification in France from 2011 to 2018

Introduction - The electronic certification system implemented following the 2003 heat wave allows physicians to certify deaths via a secure web application. This article describes the status of the rollout of electronic death certification in 2018 and its progress since 2011. Methods - The estimated adoption rate in 2018 is described at the national, regional, and departmental levels. The distribution of electronic certificates in 2018 by age group and type of place of death is compared to that of total mortality. The temporal evolution of adoption is presented at the national level and by region. Results - In 2018, 15.6% of deaths were certified electronically. This proportion ranged from 0.6% to 24% depending on the region. The majority of electronic certificates involved people aged 65 or older (81.6% vs. 84% of all deaths) and were recorded in hospitals (90.1% vs. 55.7% of all deaths). After remaining stable between 2011 and 2013, the rate of electronically certified deaths in France increased between 2014 and 2016, remained stable in 2017, and then saw a sharp increase in 2018. Discussion - The rollout of electronic certification remains limited and uneven across the country despite the implementation of regional initiatives, encouraged by two ministerial directives, and the implementation of technical updates to the CertDc web application aimed at removing barriers to deployment. Electronic death certification, however, offers benefits for certifying physicians and Regional Health Agencies (ARS), as well as for reactive mortality surveillance.

Author(s): Fouillet Anne, Pigeon Dominique, Carton Isabelle, Robert Aude, Pontais Isabelle, Caserio-Schönemann Céline, Rey Grégoire

Publishing year: 2019

Pages: 585-593

Weekly Epidemiological Bulletin, 2019, n° 29-30, p. 585-593

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