International Adoption of Principles of Morbidity and Mortality Classification

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Abstract
Regulation No. 1 passed by the First World Health Assembly at Geneva on July 24, 1948, provides-for the formal adoption internationally of the Sixth Revision of the Internat. Lists of Diseases and Causes of Death as well as uniform procedures in the compilation and publication of morbidity and mortality statistics. The World Health Organization is publishing the new classification in the Manual which consists of 2 volumes and will appear in English, French and Spanish editions. Volume I will contain, in addition to the Introduction, List of Categories, and Tabular List of Inclusions, a section on medical certification and rules of classification and special lists of selected causes for use in the tabulation of morbidity and mortality statistics. Volume II. will consist of a comprehensive alphabetical index of diagnoses and morbidity conditions. The rules for a uniform classification of the primary cause of death provides for the adoption of a uniform medical certificate of the cause of death and uniform rules for the selection of the main cause of death. In the U. S. the new procedure means that in selecting the unerlying cause of death in instances where more than one cause is stated on the death certificate that selection will be according to the order in which the certifying physician enters the several causes on the death certificate rather than the selection by use of the Manual of Joint Causes of Death as has been the custom in the past. This procedure follows closely the procedure which has been followed by the Registrar General of England and Wales since 1941. Special rules are given in the international manual for handling cases in which the physician has not entered the causes in their proper order. The new International Classification of Diseases, Injuries and Causes of Death and the revised joint cause procedure will open up great possibilities for improving the quality of cause-of-death statistics. However, there are a number of problems to be overcome before its full potentialities can be realized. A step in this direction has been taken by the adoption of the Internat. Medical Certificate of Death. To assist in the evaluation of the effects of the changes in the Internat. List and of classification procedures, the National Office of Vital Statistics will prepare special tabulations for 1949 based on the Fifth and Sixth Revision of the Internat. List of Causes of Death of the old and new joint-cause procedures.

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