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Gleich, S. und Graw, M. (2020): Sterbefälle Münchner Altenheimbewohner und betagter Allgemeinbevölkerung – ein Vergleich ausgestellter Todesbescheinigungen. In: Rechtsmedizin, Bd. 31, Nr. 1: S. 26-34

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Abstract

Background: Demographic change has arrived in Germany, with every fifth citizen over 66 years of age. The further increase in the number of oldest old and those in need of nursing care in the population is undisputed. Insufficient quality of medical post-mortem examinations and incorrect issuing of death certificates have been noted for many years. Methods The death certificates of all Munich deaths in 2013 and 2014 were included and the variables were entered anonymously in Microsoft Excel (Microsoft Office 2011) according to a developed key. Target collective (TC= deceased residents of nursing homes) and control collective (CC= no nursing home resident, age at death more than 75 years) were descriptively evaluated with SPSS (IBM, Version 23). Results: During the study period 4740 residents of old people's homes and 11,929 persons with a death age of more than 75 years died. The average age at death of the TC was 85 years, of the CC 84 years. Of the TC 69% were female and 53% of the CC. In the target group 75% died in nursing homes, in the control group 68% in hospital. The certified types of death were distributed differently in the target and control groups: natural 96% versus 85%, unexplained 3% versus 11%, unnatural 1% versus 3%, respectively. In the target group, the most frequent underlying diseases were diseases of the circulatory system in 46% and diseases of the nervous system in 11%, in the control group diseases of the circulatory system in 34% and malignant neoplasms in 21.5%. In the target group 3% of the doctors who issued the death certificates requested autopsies and 13% of the control group. In fact 1% of the target and 6% of the control group were actually autopsied. Conclusion The study enabled for both collectives to answer for the first time important questions about the age and place of death, the type and cause of death and the frequency of autopsies. It could be shown that both collectives differed statistically significantly from each other in all questions examined. It was also shown that the causes of death of the target collective differed from the official cause of death statistics. There were indications of poor quality in the post-mortem examination: this particularly affected general practitioners, who certified a natural cause of death in almost all nursing home residents who died in their institution and at the same time indicated an imprecise or unexplained direct cause of death in almost 20% of cases

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