Mackenbach J P, Looman C W, Kunst A E, Habbema J D, van der Maas P J
Department of Public Health and Social Medicine, Erasmus University Rotterdam, The Netherlands.
Soc Sci Med. 1988;27(9):889-94. doi: 10.1016/0277-9536(88)90278-x.
In order to assess the impact of medical care innovations on post-1950 mortality in The Netherlands, we analysed trends in mortality from a selection of conditions suggested by Rutstein et al.'s lists of "unnecessary untimely mortality". This selection covers 11 types of innovation, and includes 35 conditions which have become amenable to medical care. Loglinear regression analysis shows that for most of these conditions mortality declined during each of two subperiods (1950-1968; 1969-1984). Mortality decline accelerated in the second subperiod for many conditions. Reductions in mortality from these conditions between 1950/54 and 1980/84 added 2.96 and 3.95 years to life expectancy at birth of Dutch males and Dutch females respectively. A priori evidence indicates that these mortality reductions are due to some extent to 'spontaneous' incidence declines. Although the exact contribution of medical care innovations to these changes in mortality thus cannot be determined, the impact of medical care on post-1950 mortality in The Netherlands could well have been substantial.
为评估医疗创新对荷兰1950年后死亡率的影响，我们分析了鲁特斯坦等人列出的“不必要的过早死亡”清单中所提及的部分疾病的死亡率趋势。该清单涵盖11种创新类型，包括35种已可通过医疗手段治疗的疾病。对数线性回归分析表明，在两个子时期（1950 - 1968年；1969 - 1984年）中的每个时期，这些疾病中的大多数死亡率都有所下降。在第二个子时期，许多疾病的死亡率下降加速。1950/54年至1980/84年期间，这些疾病死亡率的降低分别使荷兰男性和女性的出生时预期寿命增加了2.96岁和3.95岁。先验证据表明，这些死亡率的降低在一定程度上归因于发病率的“自然”下降。因此，虽然无法确定医疗创新对这些死亡率变化的确切贡献，但医疗对荷兰1950年后死亡率的影响很可能是巨大的。
