The incomparability of cause of death statistics under “one country, two systems”: Shanghai versus Hong Kong

Table 1 Comparison of institutional structures of death registration systems in Hong Kong and Shanghai

Data compilation process		Hong Kong	Shanghai
Coverage	Compulsory registration of death events	Yes	Yes
	Required time for registration after death	24 hours	Before cremation
	Coverage	De-facto (All deaths within the territory)	De-jure (permanent residents of Shanghai based on household register)
	Number of physicians per 10,000 population in 2008	18	27
Data initiation	Who certifies death for those dying in hospital	Attending doctors	Attending doctors
Data initiation	Who certifies death for those dying outside hospital without a doctor attending	Coroners	Non-criminal: community doctors; Criminal: police
COD^a coding	Coding rule of COD	ICD-10 (ACME)^b	ICD-10 (Manual)
Data audit	Clinical record review for COD	If person dies from infectious disease; deaths with insufficient information to determine UCD	Case of death when the causal sequence is not specific or only the mechanism of death is reported
Data audit	Training for physicians to certify death	No	Yes

^aCause of death
^bAutomated Classification of Medical Entries
Sources of data: Shanghai Municipal Statistical Bureau, National Bureau of Statistics Survey (Shanghai Groups) (2009) [18]; The Hong Kong Council of Social Service (2016) [19]; Zhao (2013) [20].

ISSN: 1478-7954