الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Analysis of mortality data is one of the basic fundamental indcators for assessing the heal th status and determining the changing pattern of cause of death of a population. They also provide a suseful tool for evaluation of health services and determination of high risk groups. I n Egypt and most of the developing countries, records concerning the cause of death are sometimes laking accuracy and this may resul t from middaignosis and/or improper tabulation according to lCD categories. This study was performed ’with the aim of identi fying the U.C.D. in the two main health insurance hospitals in Alexandria (Gamal Abdel-Nasser and Karmouz hospitals) and their analysis in relation to various selected factors as age, sex, occupational, seasonal variation, previous relevant admissions, provisional and final diagnoses and associated conditions. al so identifcation of the degree of inc 1 uding re 1 evant cl incal data and investigations in the death certificates was reported as an ondex to measure the quality of recording the cause of death. Furthermore, the present study, conducted an assessment of quality of care by using the expl ici -I: process cri teria for the three leading U.e.D., namely ~ute myocardial infarction, e.v.s. and chronic renal failure. To accomplish this work a 50 sample of medical records of mortal i ties was se 1 ected from thr two hospital s during the year 1989. A data collection sheet was designed to abstract data from the medical records. The diagnosis of cause of de.ath was performed through examination of death certificate included in the record by ~ing rules for identification of U.e.D. prepared by W.H.O. The sample size was 615 deaths in Gamal hospital and 191 deaths in Karmouz hospital ( atotal of 806 deaths). After identification of the most leading causes of death and review of literature concerning chart audit for the three 1 eading causes of death, an expl ici t criteria of care for each cause was validated by specialists to develop data of care collection sheet to indicate the degree of compl iance for each item of criteria. The study revealed the following results: 1. The gross death rate in Gamal hospital was double that of Karmouz being 4.2 and 2.1 respectively. The net death rate in Gamal hospital was 2.1 and in Karmouz it was 1.1 . 2. The proportion of deaths in both hospitals increases with the advance of age reached the.peak in the age group 45 to less than 55 years. The proportion of male deaths predominate that of femal e one. J.<:I:U 3 There is no relation between the proportion of deaths and the day of week of admission. 4. Mortality in Spring and Winter excedded that of Summer and Autumn. 5. The proportion of deaths was higher among retired followed by worker/technicians with no significant difference between the two hospitals. 6. the main leading causes of death among the insured population according to 17 ICD diagnostic categories were cardiovascular system diseases, neoplasms, and infectious and parasitic diseases with no signifi~ant difference between the two hospitals. 7. The main leading causes of death in both hospital s were I. H. D. , (18.1),C.V.S.(16.9) and malignant neoplasms (15.6). The most common U.C.D. in Gamal was I.H.D. and in Karmouz it was C.V.S. 8. Cancer of digestive system represented more than one third of all cancer deaths (37.3). Cancer of geni tourinary system ranked second (17), followed by lymphomas (13). 9. The leading cause of death varied with age. Mal ignant neoplasms and chronic renal failure consituted the most encountered cause 141 ~ of death among the age group below 40 years (18.5 and 17.3 I . respectively) .