Declining Amenable Mortality: Time Trend (2000-2013) and Geographic Area Analysis

Health Serv Res. 2017 Oct;52(5):1908-1927. doi: 10.1111/1475-6773.12563. Epub 2016 Oct 5.

Abstract

Objective: To update amenable mortality in 32 OECD countries at 2013 (or last available year), to describe the time trends during 2000-2013, and to evaluate the association of these trends with various geographic areas.

Data sources: Secondary data from 32 countries during 2000-2013, gathered from the World Health Organization Mortality Database.

Study design: Time trend analysis.

Data collection: Using Nolte and McKee's list, age-standardized amenable mortality rates (SDRs) were calculated as the annual number of deaths over the population aged 0-74 years per 100,000 inhabitants. We performed a mixed-effects polynomial regression analysis on the annual SDRs to determine whether specific geographic areas were associated with different SDR trajectories over time.

Principal findings: The OECD average annual decrease was 3.6/100,000 (p < .001), but slowed over time (coefficient for the quadratic term = 0.11, p < .001). Eastern and Atlantic European countries had the steepest decline (-6.1 and -4.7, respectively), while Latin American countries had the lowest slope (-1.7). The OECD average annual decline during the 14-year period was -0.5 (p < .001) for cancers and -2.5 (p < .001) for cardiovascular diseases, with significant differences among countries.

Conclusion: Declining trend of amenable SDRs was continuing to 2013 but with steepness change compared with previous periods and with a slowdown.

Keywords: Amenable mortality; OECD countries; geographic area; health care services performance.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cause of Death
  • Child
  • Child, Preschool
  • Developed Countries / statistics & numerical data*
  • Female
  • Global Health
  • Health Services Accessibility
  • Healthcare Disparities
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Mortality / trends*
  • Quality of Health Care
  • Young Adult