Jougla E, Ducimetière P, Bouvier-Colle M H, Hatton F
INSERM U. 164, Chemin de Ronde, B.P. 34, Le Vésinet.
Rev Epidemiol Sante Publique. 1987;35(5):365-77.
"Avoidable" mortality may be defined as a selection of causes of death whose occurrence is closely related to medical intervention. We have attempted to relate the variations in mortality from these selected causes to health service input among the 95 French departments. This analysis was controlled for social factors. Firstly we performed independently two factor analysis of the departmental variations in health care variables and in social factors. These studies were carried out with the aim of creating new discriminant and independent variables. Multiple stepwise regressions were then used to analyse the independent and joint associations of these new variables with mortality. The data show principally the considerable weight of social factors in explaining mortality differences. On the contrary, we found very weak relationships between health service input and mortality. However in view of the analysis method, it would appear unjustified to interpret this result in terms of a criticism of the "avoidable" mortality concept.
“可避免的”死亡率可定义为一组与医疗干预密切相关的死因。我们试图将这些选定死因的死亡率变化与法国95个省的卫生服务投入联系起来。该分析对社会因素进行了控制。首先,我们分别对各省在医疗保健变量和社会因素方面的差异进行了双因素分析。进行这些研究的目的是创建新的判别变量和独立变量。然后使用多元逐步回归分析这些新变量与死亡率的独立关联和联合关联。数据主要表明社会因素在解释死亡率差异方面具有相当大的权重。相反,我们发现卫生服务投入与死亡率之间的关系非常微弱。然而,鉴于分析方法,从对“可避免的”死亡率概念的批评角度来解释这一结果似乎是不合理的。