2026-11-092026-11-09https://scholars.csmu.edu.tw/handle/123456789/37568Due to the aging of the population, a number of conditions existed during the death, which render the certifier and coder difficulty in selecting a single underlying cause of death. Multiple cause of death (MCOD) statistics was proposed by the scholars to solve the above problem. MCOD is especially valuable in analyzing the conditions which unlikely to be the underlying cause of death, e.g., hypertension, renal diseases, dementia, diabetes or injuries. This study plan to systematically sample 5% of death certificates issued in 1998, 1994 and 1998 for MCOD analysis. The first aim of this study is to determine the changes of numbers of causes of death entered by death certifiers during the ten years. The second aim is to assess the changes of relative numbers of some causes of death (e.g., hypertnesion, diabetes, liver cirrhosis, dementia, etc.) as underlying cause of death or contributory cause of death. The third aim is to evaluate the changes of the coding practices. The forth aim is to discuss the potential of using pattern of MCOD association analysis in epidemiological research.由於人口老化造成死亡時，死者經常是多重疾病並存，使開具醫師相當困難選擇單一原死因鏈。此外，傳統選擇單一原死因統計製表的作法也犧牲了許多填在死亡證明書的原死因以外相關訊息，譬如併發症、後遺症、伴隨死因、競爭死因、輔助死因、相關身體狀況等。所以長久以來都有學者主張在單一原死因統計製表外，應該增加多重死因統計的編撰。隨著電腦化原死因選擇系統的普遍化，多重死因統計的技術大為提昇，相關研究數目也逐年增加。許多過去被低估死因（高血壓、糖尿病、肝硬化、精神疾病、關節炎、肺部疾病、腎臟疾病）的絕對數目、相對數目與疾病組合改變也逐漸明朗，對醫療保健計畫評估與病因學研究都提供相當重大的訊息。台灣將於民國90年採用美國電腦化原死因選擇系統，因此也同時可進行多重死因統計，本研究一方面收集國外資料建議台灣多重死因統計報表格式；另一方面將以民78、83、88年死因統計資料（每年抽樣五分之一）進行分析，提供上述訊息的十年趨勢分析。死亡證明書死亡率死因多重死因國際疾病分類Death certificatesMortalityCause of deathMultiple cause of deathInternational Classification of DiseaseProject