Health and Healthcare policy program, RAND Europe, Cambridge, England.
Health Aff (Millwood). 2012 Sep;31(9):2114-22. doi: 10.1377/hlthaff.2011.0851. Epub 2012 Aug 29.
We examined trends and patterns of amenable mortality-deaths that should not occur in the presence of timely and effective health care-in the United States compared to those in France, Germany, and the United Kingdom between 1999 and 2007. Americans under age sixty-five during this period had elevated rates of amenable mortality compared to their peers in Europe. For Americans over age sixty-five, declines in amenable mortality slowed relative to their peers in Europe. Overall, amenable mortality rates among men from 1999 to 2007 fell by only 18.5 percent in the United States compared to 36.9 percent in the United Kingdom. Among women, the rates fell by 17.5 percent and 31.9 percent, respectively. Although US men and women had the lowest mortality from treatable cancers among the four countries, deaths from circulatory conditions-chiefly cerebrovascular disease and hypertension-were the main reason amenable death rates remained relatively high in the United States. These findings strengthen the case for reforms that will enable all Americans to receive timely and effective health care.
我们考察了 1999 年至 2007 年间美国与法国、德国和英国之间可避免死亡率(即本应在及时、有效的医疗保健条件下避免发生的死亡)的趋势和模式。在此期间,美国 65 岁以下人群的可避免死亡率高于欧洲同龄人。对于 65 岁以上的美国人,可避免死亡率的下降速度相对于欧洲同龄人有所放缓。总体而言,1999 年至 2007 年期间,美国男性的可避免死亡率仅下降了 18.5%,而英国则下降了 36.9%。女性的死亡率分别下降了 17.5%和 31.9%。尽管在这四个国家中,美国男性和女性因可治疗癌症而导致的死亡率最低,但死于循环系统疾病(主要是脑血管病和高血压)是导致美国可避免死亡率仍相对较高的主要原因。这些发现进一步支持了进行改革的必要性,这将使所有美国人都能获得及时、有效的医疗保健。