可避免死亡率能告诉我们关于地区卫生系统绩效的哪些信息（如果有的话）？
What, if anything, does amenable mortality tell us about regional health system performance?
作者信息
Lavergne M Ruth, McGrail Kimberlyn
机构信息
Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
出版信息
Healthc Policy. 2013 Feb;8(3):79-90.
OBJECTIVES
Amenable mortality is proposed as a health system performance measure, and has been used in comparisons across countries and socio-economic strata. We assess its utility as a health region–level indicator in Canada.
APPROACH
We classified all deaths in British Columbia from 2002 to 2009 using two common definitions of amenable mortality. Counts and standardized rates were calculated for 16 health regions. To assess reliability, sensitivity and validity, we compared rates across regions and over time, and examined correlations with premature and all-cause mortality.
RESULTS
Of the 238,849 deaths in the study period, 6.6% or 13.7% were classified as amenable (depending on the definition used). Rates were stable or falling in more populated regions, but unstable with large confidence intervals elsewhere. Correlation with overall mortality was strong.
CONCLUSION
Though amenable mortality is appealing as a feasible, understandable indicator, we question whether it is appropriate for comparisons at a subprovincial level.
目的
可避免死亡被提议作为一种卫生系统绩效衡量指标，并已用于各国及社会经济阶层间的比较。我们评估其作为加拿大卫生区域层面指标的效用。
方法
我们采用两种常见的可避免死亡定义，对2002年至2009年不列颠哥伦比亚省的所有死亡病例进行分类。计算了16个卫生区域的病例数和标准化率。为评估可靠性、敏感性和有效性，我们比较了各区域间及不同时间的比率，并研究了与过早死亡和全因死亡率的相关性。
结果
在研究期间的238,849例死亡病例中，6.6%或13.7%被归类为可避免死亡（取决于所使用的定义）。人口较多地区的比率稳定或下降，但其他地区不稳定，置信区间较大。与总体死亡率的相关性很强。
结论
尽管可避免死亡作为一个可行、易懂的指标很有吸引力，但我们质疑它是否适合在省级以下层面进行比较。
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