Milestones in the CDC 122 Cities Mortality Reporting System: A 2012 Reporter Survey

BACKGROUND:   The 122 Cities Mortality Reporting System (122 CMRS) is one of two national surveillance systems that monitor influenza-related mortality and is the most timely source of national mortality data in the United States.  The total number of death certificates filed and the number of death certificates in which pneumonia and/or influenza (P&I) are listed anywhere are reported weekly from 122 participating cities in the U.S. The goal of the survey was to ascertain mortality reporting practices, reporting jurisdiction, availability of electronic death data, determine the size of the population within the reporting jurisdiction, and to determine how influenza and pneumonia deaths were defined among the 118 CMRS currently participating cities.

METHODS:   A brief questionnaire was sent to all participant cities on August 30, 2012, and surveys were requested to be returned within two weeks.   Follow-up was conducted by email and telephone calls.

RESULTS:   118 (100%) participant cities returned the survey, with 81/118 (69%) of the cities responding within two weeks of receiving the survey.  Few participant cities (3/118 (2.5%)) experienced minimal changes in their reporting areas, compared to the 2009 reporter survey.  The majority of cities, (105/118 (89%)) cities reported all deaths occurring within their jurisdiction regardless of the residence of the decedent; 11 cities reported only deaths of residents that occurred in their jurisdiction.  Although 75 cities continue to generate mortality counts manually, 43/118(36%) of the cities abstracted data from electronic death records by using text or by using ICD-10 codes.  Of the 73 cities that reported the availability of the Electronic Death Reporting System (EDRS) in their jurisdiction, only 52/73 (71%) derived more than 95% of mortality data from the EDRS.  Influenza and pneumonia deaths were reported by 109/118 (92%) of participant cities if they were listed anywhere in Part I or Part II of the death certificate.  The remaining nine cities reported influenza and pneumonia if it was listed as an underlying cause on the death certificate.  All deaths registered and included in the weekly mortality were reported by 108/118 (92%) cities within 1-2 weeks of their occurrence.  Six cities reported an average lag between date of death and report to CDC of >2 weeks.

CONCLUSIONS:  The current survey indicates that the geographic coverage by 122 CMRS reporting is stable.  The 122 CMRS data continues to be a reliable source of current mortality data.