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Logo of jepicomhInstructions for authorsCurrent TOCJournal of Epidemiology and Community Health
J Epidemiol Community Health. Jun 1990; 44(2): 106–111.
PMCID: PMC1060615

"Avoidable" mortality and health services: a review of aggregate data studies.

Abstract

STUDY OBJECTIVE--The aim of the study was to review published work reporting mortality from conditions amenable to medical intervention and compare the methods used and the results obtained. SOURCE MATERIAL--Two types of analysis were examined: (1) analyses of time trends, relating decline in mortality from amenable conditions to improvements in medical care (3 papers); (2) analyses of geographical variation, either between or within countries, in which mortality was related to the availability of health care resources and to other factors (8 papers). RESULTS--Time-trend studies have in general shown that mortality from amenable causes has declined faster over the past decades than most other causes of death. Studies of geographical variation have shown that mortality from amenable causes is consistently associated with socioeconomic factors, and that the association with the provision of health care resources is rather weak and inconsistent. CONCLUSIONS--(1) The low levels of mortality from amenable causes which presently prevail in industrialised countries are likely to reflect, at least in part, the increased effectiveness of health services; (2) geographical variation in mortality from amenable causes has not yet been shown to reflect differences in effectiveness of health services; and (3) if geographical variation in avoidable mortality does reflect such differences, they must arise from circumstances other than the level of supply, for example from more specific aspects of health care delivery, and are probably closely related to socioeconomic circumstances. In depth studies at the individual level are now more likely to produce information about factors limiting the effectiveness of health services than further studies of aggregate data.

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Selected References

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  • Rutstein DD, Berenberg W, Chalmers TC, Child CG, 3rd, Fishman AP, Perrin EB. Measuring the quality of medical care. A clinical method. N Engl J Med. 1976 Mar 11;294(11):582–588. [PubMed]
  • Rutstein DD, Berenberg W, Chalmers TC, Fishman AP, Perrin EB, Zuidema GD. Measuring the quality of medical care: second revision of tables of indexes. N Engl J Med. 1980 May 15;302(20):1146–1146. [PubMed]
  • Charlton JR, Hartley RM, Silver R, Holland WW. Geographical variation in mortality from conditions amenable to medical intervention in England and Wales. Lancet. 1983 Mar 26;1(8326 Pt 1):691–696. [PubMed]
  • Humblet PC, Lagasse R, Moens GF, Wollast E, van de Voorde H. La mortalité évitable en Belgique. Soc Sci Med. 1987;25(5):485–493. [PubMed]
  • Jougla E, Ducimetière P, Bouvier-Colle MH, Hatton F. Relation entre le niveau de développement du système de soins et le niveau de la mortalité "évitable" selon les départements francais. Rev Epidemiol Sante Publique. 1987;35(5):365–377. [PubMed]
  • Bauer RL, Charlton JR. Area variation in mortality from diseases amenable to medical intervention: the contribution of differences in morbidity. Int J Epidemiol. 1986 Sep;15(3):408–412. [PubMed]
  • Charlton JR, Velez R. Some international comparisons of mortality amenable to medical intervention. Br Med J (Clin Res Ed) 1986 Feb 1;292(6516):295–301. [PMC free article] [PubMed]
  • Kunst AE, Looman CW, Mackenbach JP. Medical care and regional mortality differences within the countries of the European community. Eur J Popul. 1988;4(3):223–245. [PubMed]
  • Mackenbach JP, Looman CW, Kunst AE, Habbema JD, van der Maas PJ. Post-1950 mortality trends and medical care: gains in life expectancy due to declines in mortality from conditions amenable to medical intervention in The Netherlands. Soc Sci Med. 1988;27(9):889–894. [PubMed]
  • Mackenbach JP, Kunst AE, Looman CW, Habbema JD, van der Maas PJ. Regional differences in mortality from conditions amenable to medical intervention in The Netherlands: a comparison of four time periods. J Epidemiol Community Health. 1988 Dec;42(4):325–332. [PMC free article] [PubMed]
  • Carr-Hill RA, Hardman GF, Russell IT. Variations in avoidable mortality and variations in health care resources. Lancet. 1987 Apr 4;1(8536):789–792. [PubMed]
  • Poikolainen K, Eskola J. The effect of health services on mortality: decline in death rates from amenable and non-amenable causes in Finland, 1969-81. Lancet. 1986 Jan 25;1(8474):199–202. [PubMed]
  • Poikolainen K, Eskola J. Health services resources and their relation to mortality from causes amenable to health care intervention: a cross-national study. Int J Epidemiol. 1988 Mar;17(1):86–89. [PubMed]
  • Holland WW. The "avoidable death" guide to Europe. Health Policy. 1986;6(2):115–117. [PubMed]

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