Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.
University College London, London, United Kingdom.
Soc Sci Med. 2021 Jun;278:113937. doi: 10.1016/j.socscimed.2021.113937. Epub 2021 Apr 20.
The study had a three-fold objective: (i) to estimate the amenable mortality rates and trends at a national and state level between 2000 and 2015 in Mexico; (ii) to estimate the contribution and trends of various causes of death to overall amenable mortality; and (iii) to determine the association between health system inputs and amenable mortality for the period 2000-2015. We used a panel dataset for the period 2000-2015. The following health care inputs were used in the analysis: density of general practitioners, specialists and nurses, as well as density of hospital beds. We find that amenable mortality fell from 136 per 100,000 in 2000, to 124.1 per 100,000 in 2015 nationally, with significant heterogeneity in the trends across states. Mortality due to infectious diseases, diseases of childhood, and cardiovascular diseases decreased, while deaths due to other non-communicable diseases, such as diabetes, increased. There was a significant negative association between the density of general practitioners and specialist physicians, and amenable mortality. Our results indicate that reducing the burden of non-communicable diseases must be a health system priority. Improvements in primary health care could lead to improved disease detection and earlier diagnosis which could further reduce amenable mortality in Mexico.
（i）估计 2000 年至 2015 年期间墨西哥全国和各州的可避免死亡率及其趋势；（ii）估计各种死因对总可避免死亡率的贡献和趋势；以及（iii）确定 2000-2015 年期间卫生系统投入与可避免死亡率之间的关系。我们使用了 2000-2015 年期间的面板数据集。在分析中使用了以下医疗保健投入：普通医生、专家和护士的密度，以及医院床位的密度。我们发现，可避免死亡率从 2000 年的每 10 万人 136 人下降到 2015 年的每 10 万人 124.1 人，各州的趋势存在显著差异。传染病、儿童疾病和心血管疾病导致的死亡率下降，而糖尿病等其他非传染性疾病导致的死亡率上升。普通医生和专科医生的密度与可避免死亡率之间存在显著的负相关关系。我们的研究结果表明，减轻非传染性疾病的负担必须成为卫生系统的重点。改善初级卫生保健可能会导致疾病检测的改善和更早的诊断，从而进一步降低墨西哥的可避免死亡率。
