Weber Anke, Clerc Marie
Hamm-Lippstadt University of Applied Sciences, Department 2, Marker Allee 76-78, 59063 Hamm, Germany.
Eurostat, Health Administrative Data, Luxembourg.
Health Policy. 2017 Jun;121(6):644-652. doi: 10.1016/j.healthpol.2017.03.017. Epub 2017 Apr 1.
Amenable mortality has been recently included in the joint monitoring tool by the European Commission and Member States to assess a country's health system performance. Amenable deaths are premature deaths, which should not have occurred at this stage in the light of timely and effective health care. This paper recalculated annual amenable mortality rates for 28EU countries and the EU for the period 1994-2013 based on the recently published list of deaths amenable to health care by Eurostat. Thereby, it offers a consistent calculation of amenable mortality across European Member States and provides time series data on amenable mortality. In addition, a sensitivity analysis of the amenable mortality indicator for varying age limits and attributional weights of circulatory system diseases is carried out. While large improvements were made in reducing amenable deaths in all European countries, great variations persist among Member States. Most of the decreases in amenable mortality are explained by a substantial reduction of deaths due to circulatory system diseases. In addition, even in countries with good national performance on amenable mortality, sub-national analysis shows that great regional disparities exist. The sensitivity analysis revealed that for the large majority of countries results are stable across different attributional weights used for ischaemic heart diseases and cerebrovascular diseases.
欧洲委员会和成员国在联合监测工具中纳入了可避免死亡情况,以评估一个国家的卫生系统绩效。可避免死亡是指过早死亡,鉴于及时有效的医疗保健,这类死亡在现阶段本不应发生。本文根据欧盟统计局最近公布的可通过医疗保健避免的死亡清单,重新计算了1994年至2013年期间28个欧盟国家及欧盟整体的年度可避免死亡率。由此,它提供了欧洲各成员国之间可避免死亡的一致计算方法,并提供了可避免死亡的时间序列数据。此外,还对可避免死亡指标在不同年龄限制和循环系统疾病归因权重情况下进行了敏感性分析。虽然所有欧洲国家在减少可避免死亡方面都取得了很大进展,但成员国之间仍存在很大差异。可避免死亡率的下降主要是由于循环系统疾病导致的死亡大幅减少。此外,即使在可避免死亡方面国家表现良好的国家,次国家层面的分析也表明存在很大的地区差异。敏感性分析显示,对于绝大多数国家来说,在用于缺血性心脏病和脑血管疾病的不同归因权重下,结果是稳定的。