Redistributing Ill-defined Causes of Death – A Case Study from the Burden 2020-Project in Germany

Abstract Background The cause of death statistics in Germany include a relatively high share (26% in 2017) of ill-defined deaths (IDD). To make use of the cause of death statistics for Burden of Disease calculations we redistribute those IDD to valid causes of death.Methods The process of proportional redistribution is described in detail. It makes use of the distribution of the valid ICD-codes in the data. We use examples of stroke, diabetes, and heart failure to illustrate how IDD are reallocated. ResultsThe largest increases for both women and men can be found for lower respiratory infections, diabetes mellitus, and stroke. The numbers of deaths for these causes more than double after redistribution. ConclusionThis is the first comprehensive redistribution of IDD within the German cause of death statistics. Performing a redistribution is necessary, otherwise there would be an underreporting of certain causes of death or large numbers of deaths coded to residual or unspecific codes.