In an interview, the president of the Portuguese Federation of the Lung (FPP), José Alves, highlighted the last analysis of asthma-related mortality. Conducted in 1992, it found that only slightly over 10% of death certificates for older age groups were accurate.
He explained that this research, part of a doctoral thesis, concluded that up to the age of 35, only 40% of death certificates citing asthma were accurate. This accuracy dropped to 18% between ages 40 and 75, and further to 12% for those over 75.
“That was the reality,” Alves noted. He added that a 30% decrease in asthma mortality occurred from 1991 to 1992 and has declined steadily since, leading to very low current figures. This change results in a different presentation of mortality data by the ONDR, as many recorded causes of death related to respiratory diseases may not be accurate.
To ensure the accuracy of cause of death data, José Alves advocates the implementation of auditing methods.
“Some patients are hospitalized for pneumonia but die from myocardial infarction. Thus, we only know why they were admitted and why they died,” he stated, further illustrating this with a study case where a supposed asthma death was actually due to a motorcycle accident.
The ONDR 2024, an initiative by the FPP, examines key respiratory health indicators in Portugal, focusing on hospitalizations and mortality, as well as the progression of major respiratory diseases. The study utilized data from the Central Administration of Health Services (ACSS).
In addition to specific pathologies, three major patient groups were analyzed: all admitted patients irrespective of cause; those admitted for any reason but with a secondary respiratory diagnosis in their clinical history; and those admitted specifically for respiratory diseases.
These groups were further divided into categories based on the need for ventilation. To facilitate comparisons, the metric of deaths per 100 hospitalizations was used.
The findings indicate a “sharp reduction” in hospitalizations in 2020 due to the COVID-19 pandemic, with a partial recovery in subsequent years.
Hospital mortality peaked in 2021 with 71,305 deaths, representing a 107.8% increase from 2018’s figures of 64,034 deaths, before declining. In 2023, deaths were 93.9% (60,990) of those reported in 2018.
“Measures taken to curb the pandemic (…) continued to yield positive results even after the pandemic ended,” the report notes.
The document states that while the absolute number of deaths decreased, the percentage decline did not match this trend because hospitalizations fell more sharply – 9% compared to a 6.1% drop in deaths.
“It seems easier to change hospital admission rules than the severity of diseases,” it comments.
The ONDR report also warns that in 2023, around half of all deaths in Portugal occurred outside healthcare facilities, “raising questions about the reliability of recorded causes of death.”
“A study on the accuracy of death certificates similar to the one conducted in 1992 is advised,” the document suggests.
Read more:
