Relationship between Excess Mortality Derived from Death Counts and Age-Standardised Mortality Rates: The Case of Germany During the COVID-19 Pandemic

In Germany during COVID-19 (2020–2023), death-count–based and age-standardised mortality–based relative excess mortality (P-scores) are closely corresponding, with differences explained by weighting and baseline assumptions.

• Why it matters: Both excess-mortality methods are widely used, but their analytical link and how choices like standard population, age-grouping, and baseline period affect results are not always made explicit.
• What they did: The study derived the analytical relationship between relative excess mortality from death counts and ASMRs, then recalculated ASMRs using different standard populations, age-group definitions (including open-ended age groups), and pre-pandemic reference periods.
• The result: Analytical equivalence holds when the standard population’s age distribution matches the study population; empirically, estimates closely correspond, while standard population effects were strongest in 2020 and open-ended age-group definitions and reference periods shifted P-scores in closely corresponding ways.

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