Are Primary Care Physicians More Likely to Record Diabetes on Death Certificates?

  1. Laura N. McEwen, PHD1,
  2. Nathan E. Pomeroy, MD, MPH1,
  3. Kingsley Onyemere, MD1 and
  4. William H. Herman, MD, MPH12
  1. 1Department of Internal Medicine/Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan
  2. 2Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
  1. Address correspondence and reprint requests to Laura N. McEwen, PhD, UMHS TRIAD, P.O. Box 131337, Ann Arbor, MI 48113-1337 . E-mail: lmattei{at}med.umich.edu

Diabetes is recorded on the death certificate of decedents with known diabetes only 38–48% of the time (1–9). Few studies have examined whether recording of diabetes on death certificates is associated with the antemortem relationship between the decedent and the certifying physician. One study of 292 diabetic decedents with histories of ischemic heart disease found that if the certifying physician was the personal physician, diabetes was recorded 48% of the time, versus 33% for another physician and 8% for a medical examiner (2). Another study found that for 104 patients with diabetes who died in the hospital, there was no relationship between the level of training of the certifying physician and the recording of diabetes (7). Our objective was to examine whether primary care physicians (PCPs) are more likely than other physicians to record diabetes on the death certificates of decedents with known diabetes.

RESEARCH DESIGN AND METHODS—

The Translating Research Into Action for Diabetes (TRIAD) study has been described in detail elsewhere (10). This study was limited to the Michigan study site. Patients aged 18 years were sampled (n = 1,650). The institutional review board approved the study, and all participants provided informed consent.

A baseline survey was administered to TRIAD participants either by computer-assisted telephone interview or by mail, …

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