Cent Eur J Public Health 2017, 25(Suppl 2):S16-S22 | DOI: 10.21101/cejph.a4956

Mortality amenable to health care in European Union countries and its limitations

Peter Jarčuška1, Martin Janičko1, Miroslav Barták2, Beáta Gavurová3, Tatiana Vagašová3
1 1st Department of Internal Medicine, University Hospital and Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Košice, Slovak Republic
2 Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
3 Faculty of Economics, Technical University of Košice, Košice, Slovak Republic

Aim: The concept of amenable mortality is intended to assess health care system performance. It is defined as "premature deaths that should not occur in the presence of timely and effective health care". The purpose of paper is to analyse differences in amenable mortality across European Union countries and to determine the associations between amenable mortality and life expectancy at birth.

Methods: This is a cross-country and time trend analysis. Data on deaths by cause, and five-year age groups were obtained from the World Health Organization database for the 20 European Union countries, throughout the period from 2002 to 2013. The rates of amenable mortality were expressed by the age-standardised death rates per 100,000 inhabitants. We applied the method of direct standardisation using the European Standard Population.

Results: Throughout the explored period, the statistically significant variations of the age-standardised death rates in a relation to the European Union average fluctuated from 78.7 per 100,000 inhabitants (95% CI 72.4-84.9) in France to 374.3 per 100,000 inhabitants (95% CI 350.8-397.7) in Latvia. The leading causes of amenable mortality were ischaemic heart disease, cerebrovascular diseases, and colorectal cancer that accounted for, respectively, 42.2%, 19.5%, and 11.3% of overall amenable mortality. As expected, statistically significant strong negative relationship (R2 = 0.95; ρ = -0.98) between amenable mortality and life expectancy at birth was proved by linear regression. The concept has several limitations relating to the selection of causes of death and setting age threshold over time, not consideration actually available health care resources in each country, as well as differences in the prevalence of diseases among countries.

Conclusions: We found an explicit divide in amenable mortality rates between more developed countries of Western, Northern and Southern Europe, and less developed countries of Central and Eastern Europe. Increasing of amenable mortality may suggest deterioration in health care system performance.

Klíčová slova: amenable mortality, health care system performance, life expectancy, European Union countries

Vloženo: 17. říjen 2016; Revidováno: 19. prosinec 2017; Zveřejněno: 30. prosinec 2017  Zobrazit citaci

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Jarčuška P, Janičko M, Barták M, Gavurová B, Vagašová T. Mortality amenable to health care in European Union countries and its limitations. Cent Eur J Public Health. 2017;25(Supplement 2):S16-22. doi: 10.21101/cejph.a4956. PubMed PMID: 29524365.
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