Accuracy and completeness of death recording in primary care electronic health records compared with national death registrations in England using OpenSAFELY-TPP
- 1Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG
Abstract
IntroductionPrimary 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.
MethodsUsing 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.
ResultsAmong 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.
ConclusionsDeath 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.
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BibTeX
@misc{pesce2026accuracy,
title = {{Accuracy and completeness of death recording in primary care electronic health records compared with national death registrations in England using OpenSAFELY-TPP}},
author = {M. Pesce and W. J. Hulme and I. Kyomuhangi and E. Prestige and D. Evans and S. Y. Wong and B. Goldacre and S. C. Bacon and A. Mehrkar and OpenSAFELY Collaborative and B. MacKenna and A. L. Schaffer},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.14.26365028},
url = {https://www.medrxiv.org/content/10.64898/2026.10.14.26365028v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Accuracy and completeness of death recording in primary care electronic health records compared with national death registrations in England using OpenSAFELY-TPP
AU - M. Pesce
AU - W. J. Hulme
AU - I. Kyomuhangi
AU - E. Prestige
AU - D. Evans
AU - S. Y. Wong
AU - B. Goldacre
AU - S. C. Bacon
AU - A. Mehrkar
AU - OpenSAFELY Collaborative
AU - B. MacKenna
AU - A. L. Schaffer
PY - 2026
DA - 2026/10/14
PB - medRxiv
DO - 10.64898/2026.10.14.26365028
UR - https://www.medrxiv.org/content/10.64898/2026.10.14.26365028v1
AB - IntroductionPrimary 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. MethodsUsing 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. ResultsAmong 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. ConclusionsDeath 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.
ER -