Accuracy and completeness of death recording in primary care electronic health records compared with national death registrations in England using OpenSAFELY-TPP
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Introduction Primary care electronic health records (EHRs) are an important resource for health research, but death recording in primary care EHRs may be incomplete or differ from Office for National Statistics (ONS) death registrations. We used OpenSAFELY-TPP to assess the completeness and concordance of death recording and provide recommendations for using date-of-death information. Methods Using linked primary care EHRs and ONS death registrations, we assessed whether ONS-registered deaths from 2020–2025 had a primary care date of death and, where present, calculated the difference between dates. Where a primary care date was absent, we assessed death-related SNOMED CT codes. Analyses were conducted overall and by year, population subgroup, and general practice. We also examined GP registration end dates and primary-care-recorded deaths without a corresponding ONS record, including monthly patterns near the data extraction date. Results Among 1,409,275 ONS-registered deaths, 88% had the same date recorded in primary care and 8% had no corresponding primary care date. Among 1,324,995 deaths recorded in primary care, <2% had no corresponding ONS record. Deaths recorded in only one source were more frequent among people aged <45 years and those from Mixed, Asian or Asian British, Black or Black British, and Chinese or Other ethnic groups. ONS-only dates were also more frequent in London and the West Midlands. Primary-care-only deaths increased close to date of data extraction, reaching 7% in February 2026. Same-day GP deregistration increased from 9% in 2020 to 85% in 2025. Conclusions Death recording in primary care EHRs showed high completeness and concordance with ONS registrations, but discrepancies remained for recent deaths and some population groups. Data recency and population-specific completeness should therefore be considered when using linked mortality data for research.
Source: medRxiv
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: green
Funders: Laura and John Arnold Foundation, Wellcome Trust, Royal College of General Practitioners, UK Research and Innovation, National Institute for Health and Care Research, British Lung Foundation, Asthma and Lung UK, Medical Research Council, NIHR Oxford Biomedical Research Centre, National Institute for Health and Care Research Applied Research Collaboration Oxford and Thames Valley, Health Data Research UK
Awards: OpenSAFELY Phase Two, OpenSAFELY Phase Two, The OpenSafely Research Platform, G3136057049, G3983572576, The OpenSafely Research Platform, Urgent research and surveillance on Covid-19 using the new OpenSAFELY secure platform across 55 million patients' full linked primary care records, G5438782680, G7403390595, G8325158604
OpenAlex ID: W7222236563