Introduction
Methods
The China Disease Surveillance Points System
Survey of the under-reporting death cases in China
Field survey design
Data collection
Identification of missed deaths
Statistical methods
Propensity score weighting method
Variable | Estimated coefficient | Standard error | z | p |
---|---|---|---|---|
Intercept | −1.28 | 0.12 | 122.42 | <0.01 |
Urbanity(x1)(ref: rural) | ||||
Urban | −0.187 | 0.097 | 3.75 | 0.053 |
Age(x2)(ref:0-1year) | ||||
1-5 year | −0.249 | 0.076 | 10.67 | <0.01 |
Year(x3) (ref: 2009) | ||||
Year 2010 | 0.154 | 0.103 | 2.24 | 0.134 |
Year 2011 | −0.011 | 0.11 | 0.010 | 0.922 |
Highest level of hospital where disease was diagnosed(x4) (ref: provincial level) | ||||
City level | −0.432 | 0.18 | 5.49 | 0.02 |
County level | 0.156 | 0.151 | 1.08 | 0.30 |
Township level | 0.101 | 0.205 | 0.242 | 0.623 |
Village level | 0.351 | 0.301 | 1.357 | 0.244 |
Other | −0.462 | 0.244 | 3.595 | 0.058 |
No treatment | 0.134 | 0.408 | 0.109 | 0.742 |
Variable | Estimated coefficient | Standard error | z | p |
---|---|---|---|---|
Intercept | −1.860 | 0.068 | 759.88 | <0.01 |
Region(x1) (ref: East) | ||||
Central | −0.183 | 0.015 | 147.83 | <0.01 |
West | 0.419 | 0.015 | 826.06 | <0.01 |
Age(x2) (ref: 6–14 years) | ||||
15-44years | −0.036 | 0.041 | 0.797 | 0.397 |
45-64years | −0.021 | 0.038 | 0.294 | 0.587 |
65 years or older | −0.070 | 0.038 | 3.485 | 0.062 |
Year(x3) (ref: 2009) | ||||
Year 2010 | −0.007 | 0.015 | 0.227 | 0.634 |
Year 2011 | −0.068 | 0.015 | 21.856 | <0.01 |
Highest level of hospital where disease was diagnosed (x4)(ref: provincial level) | ||||
City level | −0.172 | 0.030 | 34.18 | <0.01 |
County level | 0.006 | 0.027 | 0.041 | 0.838 |
Township level | 0.058 | 0.032 | 3.369 | 0.067 |
Village level | −0.152 | 0.046 | 10.894 | 0.001 |
Other | −0.178 | 0.051 | 12.030 | <0.01 |
No treatment | 0.582 | 0.090 | 41.720 | <0.01 |
Marital status(x5) (ref: Married) | ||||
Unmarried | 0.095 | 0.054 | 3.093 | 0.079 |
Divorce | −0.391 | 0.100 | 15.357 | <0.01 |
Widowed | −0.122 | 0.044 | 7.519 | 0.006 |
Unknown | 0.428 | 0.123 | 12.178 | <0.001 |
Education (x6) (ref: Illiteracy) | ||||
Primary school | −0.015 | 0.031 | 0.240 | 0.624 |
Middle school | 0.065 | 0.033 | 3.797 | 0.051 |
University or above | −0.022 | 0.073 | 0.089 | 0.766 |
Unknown | −0.076 | 0.079 | 0.931 | 0.335 |
Occupation(x7) (ref: peasant) | ||||
Official and administrator | −0.017 | 0.053 | 0.105 | 0.746 |
Technical staff | −0.653 | 0.153 | 18.350 | <.001 |
Clerk | −0.016 | 0.130 | 0.015 | 0.904 |
Self-employed | 0.657 | 0.155 | 17.875 | <.001 |
Worker | 0.017 | 0.112 | 0.024 | 0.877 |
Unemployed and retired | −0.209 | 0.087 | 5.769 | 0.016 |
Other | 0.379 | 0.047 | 65.934 | <.001 |
Place of death(x8) (ref: Home) | ||||
Hospital | −0.151 | 0.044 | 11.892 | <0.001 |
On the way to the hospital | −0.190 | 0.070 | 7.351 | <0.001 |
Other place | 0.228 | 0.053 | 18.306 | <0.001 |
Unknown | 0.039 | 0.124 | 0.101 | 0.751 |
Cause of death(x9) (ref: other disease) | ||||
Cancer | 0.056 | 0.046 | 1.476 | 0.224 |
Cardiovascular disease | 0.098 | 0.042 | 5.44 | 0.020 |
Respiratory disease | 0.120 | 0.050 | 5.87 | 0.015 |
Nervous system disease | −0.137 | 0.09 | 2.23 | 0.135 |
Digestive system disease | −0.118 | 0.07 | 2.53 | 0.112 |
Urinary system disease | 0.036 | 0.091 | 0.16 | 0.694 |
Congenital anomalies | −0.083 | 0.211 | 0.16 | 0.693 |
Injury | −0.056 | 0.053 | 1.12 | 0.291 |
Infectious disease | −0.153 | 0.067 | 5.14 | 0.023 |
Pregnancy, childbirth and the puerperium | 0.057 | 0.265 | 0.047 | 0.829 |
CMR method
Results
Baseline characteristics of database
Variable | Proportions in DSP dataset (Pi) | Proportions in under-reporting survey dataset (Si) | (Si-Pi)^2/Pi | χ2 |
P
|
---|---|---|---|---|---|
Age | |||||
0-5 | 0.6 | 1.3 | 0.817 | 0.312 | >0.05 |
6-14 | 0.8 | 0.5 | 0.113 | ||
15-44 | 8.1 | 8.0 | 0.001 | ||
45-64 | 22.5 | 22.8 | 0.004 | ||
65+ | 67.3 | 66.9 | 0.003 | ||
Cause of death | |||||
Cancer | 23.8 | 24.1 | 0.004 | 1.239 | >0.05 |
Cardiovascular disease | 43.9 | 42.4 | 0.051 | ||
Respiratory disease | 9.0 | 11.1 | 0.490 | ||
Nervous system disease | 1.4 | 1.3 | 0.007 | ||
Digestive system disease | 2.4 | 2.3 | 0.004 | ||
Urinary system disease | 1.3 | 1.2 | 0.008 | ||
Congenital anomalies | 0.4 | 0.4 | 0.000 | ||
Injury | 8.2 | 9.0 | 0.078 | ||
Infectious diseases | 3.2 | 3.5 | 0.028 | ||
Pregnancy, childbirth and the puerperium | 0.5 | 0.6 | 0.020 | ||
Other disease | 5.9 | 4.1 | 0.549 | ||
Highest level of hospital where disease was diagnosed | |||||
Provincial level | 14.2 | 12.6 | 0.180 | 1.876 | >0.05 |
City level | 28.0 | 25.8 | 0.173 | ||
County level | 34.2 | 40. 5 | 1.124 | ||
Township level | 13.1 | 12.3 | 0.049 | ||
Village level | 3.9 | 3.8 | 0.003 | ||
Other | 5.7 | 4. 5 | 0.257 | ||
No treatment | 1.0 | 0.7 | 0.090 | ||
Diagnostic criteria | |||||
Symptoms + physio-biochemistry | 55.8 | 57.6 | 0.058 | 0.360 | >0.05 |
Pathology | 7.9 | 6.9 | 0.127 | ||
Symptoms/signs | 25.1 | 25.6 | 0.010 | ||
Autopsy | 0.6 | 0.6 | 0.000 | ||
Surgery | 1.7 | 1.4 | 0.053 | ||
Inference | 7.8 | 6.9 | 0.104 | ||
Other | 1.1 | 1.0 | 0.009 |
Variable | Crude under-reporting rates | Total | ||
---|---|---|---|---|
2009 | 2010 | 2011 | ||
Geographic region | ||||
East | 10.2(1232/12026) | 10.6(1325/12466) | 8.9(1083/12173) | 9.9 |
Central | 12.1(1223/10114) | 10.3(1044/10120) | 10.6(1079/10211) | 11.0 |
West | 19.8(1630/8241) | 18.0(1481/8229) | 17.6(1496/8517) | 18.4 |
Sex | ||||
Male | 13.1(2289/17470) | 12.3(2173/17711) | 11.8(2111/17900) | 12.4 |
Female | 13.9(1796/12911) | 12.8(1677/13104) | 11.9(1547/13001) | 12.9 |
Rural/urban | ||||
Urban | 12.1(1584/13074) | 11.1(1496/13473) | 8.9(1196/13460) | 10.7 |
Rural | 14.5(2501/17307) | 13.6(2354/17342) | 14.1(2462/17441) | 14.1 |
Age (years) | ||||
0-5 | 17.4(76/438) | 22.0(89/405) | 19.6(64/326) | 19.6 |
6-14 | 21.2(54/255) | 17.8(48/270) | 18.2(45/248) | 19.0 |
15-44 | 13.9(372/2669) | 14.4(345/2394) | 13.8(327/2363) | 14.1 |
45-64 | 14.1(960/6833) | 12.1(827/6836) | 11.6(818/7055) | 12.6 |
65+ | 13.0(2623/20186) | 12.2(2541/20910) | 11.5(2404/20909) | 12.2 |
Cause of death | ||||
Cancer | 11.8(849/7180) | 10.2(747/7340) | 10.1(746/7420) | 10.7 |
Cardiovascular diseases | 13.6(1784/13091) | 13.2(1802/13683) | 12.0(1641/13658) | 12.9 |
Respiratory diseases | 16.3(459/2810) | 12.5(351/2802) | 13.7(373/2715) | 14.2 |
Nervous system diseases | 9.4(39/413) | 11.2(48/427) | 11.4(49/431) | 10.7 |
Digestive system diseases | 12.4(93/749) | 10.6(75/709) | 10.5(78/740) | 11.2 |
Urinary system diseases | 11.7(47/403) | 13.0(52/400) | 11.6(43/371) | 12.1 |
Congenital anomalies | 17.9(22/123) | 16.0(21/131) | 17.2(20/116) | 17.0 |
Injury | 14.1(367/2610) | 14.4(353/2448) | 12.6(318/2516) | 13.7 |
Infectious diseases | 12.1(124/1029) | 11.0(105/953) | 11.1(111/997) | 11.4 |
Pregnancy, childbirth and the puerperium | 21.3(34/160) | 27.3(39/143) | 19.8(23/116) | 22.9 |
Other diseases | 14.7(267/1813) | 14.5(257/1779) | 14.1(256/1821) | 14.4 |
Total | 13.5(4085/30381) | 12.5(3850/30815) | 11.8(3658/30901) | 12.6 |
Under-reporting rate based on propensity score weighting and CMR
Under-reporting rate based on CMR(%) | Under-reporting rate based on propensity score weighting (%) | |||||||
---|---|---|---|---|---|---|---|---|
2009 | 2010 | 2011 | Total | 2009 | 2010 | 2011 | Total | |
Geographic region | ||||||||
East | 10.2(9.7,10.8) | 10.6(10.1,11.2) | 8.9(8.4,9.4) | 9.9(9.6,10.2) | 9.9(8.4,11.0) | 10.1 (8. 7,11.3) | 10.2 (8. 7,11.3) | 10.1(8.6,11.3) |
Central | 12.1(11.5,12.7) | 10.3(9.7,10.9) | 10.6(10.0,11.1) | 11.0(10.7,11.3) | 11.1(9.5,12. 6) | 11.4 (9.7,13.0) | 11.1(9.7,13.0) | 11.2(9.6,12. 7) |
West | 19.8(18.9,20.1) | 18.0(17.2,18.8) | 17.6(16.8,18.3) | 18.4(18.0,18.9) | 18.5(16.2,20.7) | 19.0 (16.7,21.3) | 18.8 (16.7,21.3) | 18.8(16.5,21.0) |
Sex | ||||||||
Male | 13.1(12.6,13.6) | 12.2(11.2,13.2) | 11.8(11.3,12.2) | 12.4(12.3,12.8) | 12.5 (11.3,14.5) | 13.0(11.1,14.6) | 12.8 (11.0,14. 5) | 12.8(11.0,14.4) |
Female | 13.9(13.3,14.5) | 12.8(12.2,13.4) | 11.9(11.4,12.4) | 12.9(12.5,13.2) | 13.0(10.8,14.2) | 13.3 (11. 6,14.9) | 13.2 (11.5,14.8) | 13.2(11.4,14.7) |
Rural/urban | ||||||||
Urban | 12.1(11.6,12.7) | 11.1(11.0,11.6) | 8.9(8.4,9.4) | 10.7(10.4,11.0) | 11.0 (9.3,12. 6) | 11.4(9.6,13.0) | 11.3(9.6,12.8) | 11.2 (9.5,12. 8) |
Rural | 14.5(13.9,15.0) | 13.6(13.1,14.1) | 14.1(13.6,14.6) | 14.1(13.8,14.3) | 13.6 (11.9,15.3) | 14.0 (12.2,15.7) | 13.9 (12.1,15.6) | 13.9(12.1,15.5) |
Age(years) | ||||||||
0-5 | 17.3(13.7,20.6) | 21.9(17.8,25.7) | 19.6(15.1,23.6) | 19.6(17.3,21.7) | 24.0(16.3,36.0) | 23.6(16.0,35.4) | 23.6 (16.1,35.1) | 23.7 (16.1,35.5) |
6-14 | 21.1(16.0,25.6) | 17.7(13.2,21.8) | 18.1(13.3,22.4) | 19.0(16.3,21.6) | 16.0(12.7,19.4) | 15.7 (12.5,19.1) | 16.4 (13.1,20.0) | 16.0 (12.7,19.5) |
15-44 | 13.9(12.6,15.2) | 14.4(13.0,15.8) | 13.8(12.5,15.2) | 14.1(13.3,14.8) | 14.2(12.0,16.3) | 14.8 (12.5,17.0) | 14.8(12. 5,16.9) | 14.6(12.3,16.7) |
45-64 | 14.1(13.2,14.8) | 12.1(11.3,12.8) | 11.6(10.9,12.3) | 12.6(12.1,13.0) | 12.5 (10.9,13.8) | 13.0 (11.3,14.4) | 12.8 (11.2,14.2) | 12.8(11.1,14.2) |
65+ | 13.0(12.5,13.4) | 12.2(11.7,12.6) | 11.5(11.1,11.9) | 12.2 (12.0,12. 5) | 12.2 (10.9,13.8) | 12.6 (11.0,13.8) | 12.5(10.9,13.7) | 12.4 (10.9,13.6) |
Cause of death | ||||||||
Cancer | 11.8(11.1,12.5) | 10.2(9.5,10.8) | 10.1(9.4,10.7) | 10. 7(10.3,11.1) | 10.5 (9.1,11. 6) | 11.0(10.0,16.4) | 10.9(9.4,12.0) | 10.8(9.4,11.9) |
Cardiovascular disease | 13.6(13.1,14.2) | 13.2(12.6,13.7) | 12.0(11.5,12.5) | 12.9 (12.6,13.2) | 13.0(11.5,14.1) | 13.3 (11.8,14.6) | 13.2(11.7,14.4) | 13.2(11.6,14.3) |
Respiratory disease | 16.3(15.0,17.6) | 12.5(11.3,13.7) | 13.7(12.5,15.0) | 14.2 (13.5,14.9) | 14.1 (12.5,15.4) | 14.7 (13.0,16.1) | 14.7(13.0,16.0) | 14.5 (12.8,15.8) |
Nervous system disease | 9.4(6.6,12.1) | 11.2(8.2,14.0) | 11.3(8.4,14.1) | 10.7(9.0,12.3) | 11.1 (8.8,13.5) | 11.4 (9.0,13.8) | 11.2 (8.9,13. 6) | 11.3(8.9,13.6) |
Digestive system disease | 12.4(10.1,14.6) | 10.6(8.3,12.7) | 10.5(8.3,12.6) | 11.2(9. 9,12.4) | 11.3(9.2,13.3) | 11.7(9.5,13.8) | 11.6 (9.5,13.8) | 11.5 (9.4,13.6) |
Urinary system disease | 11.6(8.5,14.6) | 13.0(9.7,16.0) | 11.6(8.3,14.6) | 12.1(10.2,13.9) | 11.6 (9.3,13.9) | 12.2(9.8,14.5) | 11.9 (9.6,14.2) | 11.9 (9.6,14.2) |
Congenital anomalies | 17.8(10.7,23.8) | 15.9(9.4,21.5) | 17.1(9.9,23.2) | 17.0(13.1,20.5) | 20.3 (13.7,30.2) | 20.3 (13.6,30.4) | 20.6(14.1,29.4) | 20.4(13.8,30.0) |
Injury | 14.1(12.7,15.9) | 14.4(13.0,15.8) | 12.6(11.4,13.9) | 13.7 (12.9,14. 5) | 14.1 (11.6,17.2) | 14.7 (12.2,17.6) | 14.6(12.0,17.5) | 14. 5(11.9,17.4) |
Infectious diseases | 12.0(10.1,13.9) | 11.0(9.0,12.9) | 11.1(9.2,13.0) | 11.4 (10.3,12.5) | 11.9 (9.5,14.6) | 12.1(9.6,15.0) | 12.0(9.6,14. 6) | 12.0(9. 6,14.7) |
Pregnancy, childbirth and puerperium | 21.1(14.5,26.8) | 27.1(19.3,33.5) | 19.7(12.0,26.1) | 22.9(18.7,26.6) | 25.7 (18.7,34.8) | 26.1 (18.8,36.0) | 26.1 (18. 8,36.0) | 26.0(18.8,35.6) |
Other diseases | 14.7(13.1,16.3) | 14.4(12.9,16.0) | 14.1(12.5,15.6) | 14.4 (13.5,15.3) | 14.9(12.5,17.3) | 14.2 (12.0,16.4) | 14.4 (12.2,16.5) | 14.5 (12.3,16.7) |
Total | 13.5(13.1,13.8) | 12.5(12.1,12.9) | 11.8(11.5,12.2) | 12.6(12.4,12.8) | 12.7 (11.0,14.6) | 13.1 (11.3,14.8) | 13.0(11.2,14.6) | 12.9 (11.2,14.6) |
Life tables
Male | Female | |||
---|---|---|---|---|
Unadjusted | Adjusted | Unadjusted | Adjusted | |
Life expectancy at birth | 77.3 | 75. 7 | 86.4 | 81.9 |
Risk of dying between 0–5 years | 0.0098 | 0.0118 | 0.0070 | 0.0082 |
Risk of dying between 15–60 years | 0.1188 | 0.1307 | 0.0564 | 0.0615 |
Life expectancy at age 60 years | 22.4 | 21.2 | 29.6 | 24.9 |