Effect of healthcare on mortality: Trends in avoidable mortality in Australia and comparisons with Western Europe
Effect of healthcare on mortality: Trends in avoidable mortality in Australia and comparisons with Western Europe
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DOI：
10.1016/j.puhe.2005.07.006
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发表时间：
2006-02-01
期刊：
影响因子：
5.2
通讯作者：
Butter, JRG
中科院分区：
文献类型：
--
作者：
Korda, RJ;Butter, JRG
目的：使用可避免死亡率的概念，国际研究表明，医疗保健在降低死亡率方面是有效的。本文提供了一个分析，可避免的死亡率在澳大利亚和比较趋势与西欧。方法：使用单位记录的死亡率数据，我们计算了可避免的死亡率在澳大利亚1968-2001年。我们将可避免的原因分为三类：那些适合医疗护理的;那些主要对卫生政策做出反应的;以及缺血性心脏病。我们使用Poisson回归来模拟趋势。我们比较了趋势与9个欧洲国家使用公布的data.Results：总可避免的死亡率下降了68%，女性和72%的伴侣。相应的不可避免的死亡率分别为35%和33%。可避免死亡率的年下降率为：男性3.47%（95%置信区间（CI）3.44-3.50%），女性3.89%（95% CI 3.86-3.91%）。非可避免死亡率的年下降率分别为1.09%（95% CI 1.05-1.13%）和0.95%（95% CI 0.92-0.98%）。在女性中，可接受医疗护理的原因导致的死亡率下降对可避免死亡率的下降贡献了54%，缺血性心脏病贡献了45%，卫生政策干预的原因贡献了1%。在配偶中，相应的贡献分别为32%、57%和11%。这些比率，并在1980年和1998年之间的下降，与选定的欧洲国家相比，澳大利亚的排名在此期间改善。结论：在澳大利亚可避免的死亡率的趋势表明，澳大利亚的医疗保健系统已有效地改善人口健康。澳大利亚的经验与欧洲相比并不逊色。(c)2005年，皇家公共卫生研究所。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Using the concept of avoidable mortality, international studies suggest that healthcare has been effective in reducing mortality. This paper provides an analysis of avoidable mortality in Australia and compares trends with those of Western Europe.Methods: Using unit-record mortality data, we calculated avoidable mortality rates in Australia for 1968-2001. We partitioned avoidable causes into three categories: those amenable to medical care; those mainly responsive to health policy; and ischaemic heart disease. We used Poisson regression to model the trends. We compared trends with those of nine European countries using published data.Results: Total avoidable death rates fell by 68% in females and 72% in mates. The corresponding non-avoidable death rates felt by 35 and 33%. The annual declines in avoidable mortality rates were: 3.47% [95% confidence intervals (CI) 3.44-3.50%] in mates and 3.89% (95% CI 3.86-3.91%) in females. For non-avoidabte mortality rates, the annual declines were 1.09% (95% CI 1.05-1.13%) and 0.95% (95% CI 0.92-0.98%), respectively. In females, declines in death rates from causes amenable to medical care contributed 54% to the decline in avoidable mortality rates, ischaemic heart disease contributed 45%, and causes responsive to health policy intervention contributed 1%. In mates, the corresponding contributions were 32, 57 and 11%. These rates, and the declines between 1980 and 1998, were comparable with selected European countries, with Australia's ranking improving over the period.Conclusion: Trends in avoidable mortality in Australia suggest that the Australian healthcare system has been effective in improving population health. Australia's experience compares favourably with that of Europe. (c) 2005 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.