Causes of death statistics
What does the survey comprise?
Publication of data regarding the causes of death of all domestically deceased residents.
All persons with entries in the Personal Records Database (BRP) at the time of death. In principle, all persons who are expected to reside in the Netherlands for at least four months must be included in the personal records database of the municipality of residence.
Date/year survey started
This statistic has been in production since 1901.
Quarterly and annually.
Provisional figures followed by definitive figures are published in various StatLine datasets on a quarterly and annual basis.
How is the survey conducted?
The causes of death statistic is a record of all causes of death of deceased persons in the Netherlands and is compiled on a statutory basis.
For each deceased person, a cause-of-death certificate (B-certificate) is completed by a medical practitioner (certifier). This certificate is either sent by mail in a sealed envelope via the municipality where the death occurred or digitally and directly as part of a pilot project (pending amendment of the Burials and Cremations Act (Wlb)) by way of a secure electronic connection to the medical officer of Statistics Netherlands. The certificates are processed at the premises of Statistics Netherlands. Data are processed anonymously: the name of the deceased person is not known to Statistics Netherlands.
The cause-of-death certificate must be completed by the medical practitioner (certifier) who attended the deceased. This is usually the attending physician and sometimes an acting physician, a municipal coroner or a medical practitioner appointed by the Public Prosecutor.
Scope of registration
Over the past decade, the annual number of deaths in the Netherlands has been in the range of 130 thousand to 155 thousand.
Monitoring and calculation
Statistics Netherlands checks the data for completeness based on mortality records it has received from the Personal Records Database (BRP). In case of unclear or incomplete cause-of-death certificates, correspondence takes place with the responsible certifier. Data from the External causes of death, Traffic deaths and Causes of death statistics are compared to each other before they become definitive. Specific plausibility checks are performed prior to publication of the datasets.
More information can be found in description causes of death statistics.
Wat is the quality of the outcomes?
In 2018, cause-of-death certificates could be linked to 98.4 percent of all mortality records from the Personal Records Database (BRP). As for registration of Dutch residents who died abroad, Statistics Netherlands rarely receives a cause of death certificate. Statistics Netherlands classifies the deceased persons for whom no cause-of-death certificate was received among the cause of death described as “Other ill-defined and unspecified causes of mortality” (R99). In 2018, cause-of-death certificates could be linked to 99.6 percent of all mortality records from the Personal Records Database (BRP), not including Dutch residents who died abroad.
Causes of death are attributed specific codes obtained from the International Statistical Classification of Diseases and Related Health Problems (ICD) of the World Health Organisation (WHO) (https://www.who.int/classifications/en/), which is an internationally applied code list.
Statistics Netherlands has worked with the 10th Revision of the ICD (ICD-10, WHO) as of the 1996 statistical year. All data were encoded entirely manually by the medical encoders at CBS up to and including the year 2012. As of the 2013 statistical year, the cause-of-death certificates have (partly) been coded automatically using the Iris international software program (https://www.dimdi.de/dynamic/en/classifications/iris-institute/index.html).
Approximately 93 percent of all natural causes of death in the annual dataset are coded by Iris. The remainder of this dataset as well as external causes of death and maternal and perinatal deaths are still coded manually. The automatic coding of causes of death has resulted in improved international comparability and reproducibility of the data. The introduction of automatic coding in 2013 and, with it, the implementation of all updates of the ICD-10 resulted in (sole) shifts in the statistics. The most striking changes were a significant rise in mortality from dementia (including Alzheimer’s), the delayed effects of cerebrovascular accidents (CVA), as well as the significant decline in pneumonia and COPD as underlying causes of death.
Description of quality strategy
The Iris-aided coding and the implementation of annual ICD-10 updates have resulted in improved international comparability and reproducibility of the data. More correspondence has been taking place with the certifiers since 2005, with further improvements in the quality of the data as a result.