Mortality amenable to health care and its relation to socio-economic status in Hungary, 2004–08

Nagy, Csilla; Juhász, Attila; Beale, Linda; Páldy, Anna

doi:10.1093/eurpub/ckr143

Cited by 28 publications

(23 citation statements)

References 20 publications

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“…Up to now, there are some studies that assessed the regional differences in amenable mortality, e.g. for Italy (28), for Spain (29), for Hungary (30), etc. This seems to be the subject of our further analyses in the field of amenable mortality studies.…”

Section: Discussionmentioning

confidence: 99%

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

Jarčuška

Janíčko

Barták

et al. 2017

Cent Eur J Public Health

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SUMMARYAim: 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 (R 2 = 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.

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Section: Discussionmentioning

confidence: 99%

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

Jarčuška

Janíčko

Barták

et al. 2017

Cent Eur J Public Health

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“…For example, Tobias and Yeh found that amenable causes make an important contribution to the mortality differentials between socio-economic groups in New Zealand, with data from 1981–84 and 2001–04 [8]. Furthermore, Nagy, et al, examining data from 2004 to 2008, found a relationship between the risks of death due to amenable causes and deprivation in geographical areas of Hungary [22]. Schoenbaum, et al provided evidence of excessive amenable mortality in areas with higher populations of poor and black people in the US in 2005 [21].…”

Section: Discussionmentioning

confidence: 99%

Trends in socioeconomic inequalities in amenable mortality in urban areas of Spanish cities, 1996–2007

et al. 2014

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BackgroundWhile research continues into indicators such as preventable and amenable mortality in order to evaluate quality, access, and equity in the healthcare, it is also necessary to continue identifying the areas of greatest risk owing to these causes of death in urban areas of large cities, where a large part of the population is concentrated, in order to carry out specific actions and reduce inequalities in mortality. This study describes inequalities in amenable mortality in relation to socioeconomic status in small urban areas, and analyses their evolution over the course of the periods 1996–99, 2000–2003 and 2004–2007 in three major cities in the Spanish Mediterranean coast (Alicante, Castellón, and Valencia).MethodsAll deaths attributed to amenable causes were analysed among non-institutionalised residents in the three cities studied over the course of the study periods. Census tracts for the cities were grouped into 3 socioeconomic status levels, from higher to lower levels of deprivation, using 5 indicators obtained from the 2001 Spanish Population Census. For each city, the relative risks of death were estimated between socioeconomic status levels using Poisson’s Regression models, adjusted for age and study period, and distinguishing between genders.ResultsAmenable mortality contributes significantly to general mortality (around 10%, higher among men), having decreased over time in the three cities studied for men and women. In the three cities studied, with a high degree of consistency, it has been seen that the risks of mortality are greater in areas of higher deprivation, and that these excesses have not significantly modified over time.ConclusionsAlthough amenable mortality decreases over the time period studied, the socioeconomic inequalities observed are maintained in the three cities. Areas have been identified that display excesses in amenable mortality, potentially attributable to differences in the healthcare system, associated with areas of greater deprivation. Action must be taken in these areas of greater inequality in order to reduce the health inequalities detected. The causes behind socioeconomic inequalities in amenable mortality must be studied in depth.

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“…A possible interpretation of this finding is that SDR is influenced by organizational and care delivery models and different priority settings—not by the amount of dedicated resources. Recently, Nagy et al [28] also reported a positive association between amenable mortality and deprivation status in both genders.…”

Section: Discussionmentioning

confidence: 99%

Amenable mortality as a performance indicator of Italian health-care services

Fantini

Lenzi

Franchino

et al. 2012

BMC Health Serv Res

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BackgroundMortality amenable to health-care services (‘amenable mortality’) has been defined as “premature deaths that should not occur in the presence of timely and effective health care” and as “conditions for which effective clinical interventions exist.” We analyzed the regional variability in health-care services using amenable mortality as a performance indicator. Convergent validity was examined against other indicators, such as health expenditure, GDP per capita, life expectancy at birth, disability-free life expectancy at age 15, number of diagnostic and laboratory tests per 1,000 inhabitants, and the prevalence of cancer and cardiovascular diseases.MethodsAmenable mortality rate was calculated as the average annual number of deaths in the population aged 0–74 years per 100,000 inhabitants, and it was then stratified by gender and region. Data were drawn from national mortality statistics for the period 2006–08.ResultsDuring the study period (2006–08), the age-standardized death rate (SDR) amenable to health-care services in Italy was 62.6 per 100,000 inhabitants: 66.0 per 100,000 for males and 59.1 per 100,000 for females. Significant regional variations ranged from 54.1 per 100,000 inhabitants in Alto Adige to 76.3 per 100,000 in Campania. Regional variability in SDR was examined separately for male and females. The variability proved to be statistically significant for both males and females (males: Q-test = 638.5, p < 0.001; females: Q-test = 700.1, p < 0.001). However, among men, we found a clear-cut divide in SDR values between Central and Southern Italy; among women, this divide was less pronounced. Amenable mortality was negatively correlated with life expectancy at birth for both genders (male: r = −0.64, p = 0.002; female: r = −0.88, p <0.001) and with disability-free life expectancy at age 15 (male: r = −0.70, p <0.001; female: r = −0.67, p <0.001). Amenable mortality displayed a statistically significant negative relationship with GDP per capita, the quantity of diagnostic and laboratory tests per 1,000 inhabitants, and the prevalence of cancer.ConclusionsAmenable mortality shows a wide variation across Italian regions and an inverse relationship with life expectancy and GDP per capita, as expected.

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Mortality amenable to health care and its relation to socio-economic status in Hungary, 2004–08

Cited by 28 publications

References 20 publications

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

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

Trends in socioeconomic inequalities in amenable mortality in urban areas of Spanish cities, 1996–2007

Amenable mortality as a performance indicator of Italian health-care services

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