Regional variations of amenable mortality rate in Latvia

Abstract Background Death can be considered as amenable if all or most deaths from that cause (at certain age group if appropriate) could be avoided through optimal quality of health care. Amenable mortality is one of indicators to use for assessing health system performance and outcome. Methods For amenable death causes using list of diseases and conditions from Office for National Statistics of United Kingdom (used by Eurostat). Calculation of amenable death rate (per 100000 population) for ages 0 to 74 years at regional level (six statistical regions) for time period 2015-2017, direct age-standardization to the overall national population. Results accompanied by confidence intervals (95%). Results There is a slight decline in amenable mortality of Latvia at national level over the period 2015-2017. Amenable death rate of Latvia in 2017 was 309 per 100 000 (95% CI, 308.95 - 309.05). Death rates at regional level varies from 274.34 (274.23 - 274.44) in Pieriga region to 375.49 (375.37 - 375.62) per 100 000 in Latgale region. There are no significant changes in ranking of regions for three years period. Conclusions Results shows that there are differences of amenable mortality rates between regions of Latvia. There are health inequalities between regions: Pieriga region show the best health care services performance, while Latgale displays the worst performance. There is field for deeper analysis and find better interventions for improvements at national level and reducing variability between regions. Key messages There are regional variations of amenable mortality in Latvia. Regional variations show places to reduce health inequality.

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Regional and gender variation in mortality amenable to health care services in Italy

Journal of Hospital Administration ◽

10.5430/jha.v2n3p28 ◽

2013 ◽

Vol 2 (3) ◽

pp. 28 ◽

Cited By ~ 1

Author(s):

Jacopo Lenzi ◽

Paola Rucci ◽

Giuseppe Franchino ◽

Gianfranco Domenighetti ◽

Gianfranco Damiani ◽

...

Keyword(s):

Health Care ◽

Mortality Rate ◽

Health Care Services ◽

National Level ◽

Total Mortality ◽

Linear Increase ◽

Amenable Mortality ◽

Care Services ◽

All Cause Mortality ◽

And Gender

Background: Mortality amenable to health care services (“amenable mortality”) has been defined as “premature deaths that should not occur in the presence of timely and effective health care” and as “conditions for which effective clinical interventions exist”. Although it proved to be a reliable indicator of performance of health care services in the European countries at national level, evidence about its regional variation is limited. We analyzed the regional and gender variability in the performance of health care services using the amenable mortality rate and its contribution to all-cause mortality under age 75 for the period 2006–2009. Methods: The national amenable mortality rate was calculated as the average annual number of deaths for specific causes defined according to the list of Nolte and McKee over the average population aged 0–74 years per 100,000 inhabitants in Italy. The contribution of amenable mortality to all-cause mortality (%AM) was calculated as the ratio of amenable mortality rate to all-cause mortality rate. Results were then stratified by gender, region, and year. Data were drawn from national mortality statistics for the period 2006–2009 provided by the Italian Institute of Statistics (ISTAT). Results: During the index period, in Italy the age and sex-standardized death rate amenable to health care services (SDR) was 62.4 per 100,000 inhabitants: 65.8 per 100,000 for males and 59.0 for females. Amenable mortality accounted for about one-quarter (25.3%) of total mortality under age 75: one-fifth (20.1%) for males and one-third (32.9%) for females. Southern Italy generally had higher levels of amenable mortality, both in terms of SDR and %AM, except for Puglia. However, SDRs and %AM had a different geographical pattern, which was consistent for men and women. Examination of temporal trends revealed that SDR linearly declined between 2006 and 2009 (63.9 to 61.7 per 100,000; % change = –3.4%; p = 0.021), while %AM was almost stable (25.1% to 25.7%; % change = +2.4%; p = 0.120). Piedmont, Lombardy, the autonomous province of Trento, Veneto and Campania had a linear decrease in SDR, while Abruzzo had a linear increase in SDR. Puglia had a linear increase in %AM. Conclusions: The present study contributes additional evidence on the role of amenable mortality as a synthetic indicator of the effectiveness of health care services. We argue that, in a decentralized health care system such as the Italian one, regional stratification is needed to put amenable mortality into the context of the regional specificities of health care provision. We also demonstrated that it is important to consider both SDRs and %AM, because this latter measure can give an insight on the extent to which health services can contribute to ameliorating the health of a population. Thus, consideration of both SDRs and %AM can be useful for national and regional comparisons, and can constitute the basis for evidence-based policy decision making.

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ENHANCING THE VALUE OF HEALTH CARE SERVICES AT A REGIONAL LEVEL

Review of Urban and Regional Development Studies ◽

10.1111/rurd.12058 ◽

2016 ◽

Vol 29 (1) ◽

pp. 46-62 ◽

Cited By ~ 1

Author(s):

Galina Williams

Keyword(s):

Health Care ◽

Health Care Services ◽

Regional Level ◽

Care Services ◽

Value Of Health

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Mortality amenable to health care services and health inequalities across the regions of Italy

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.510 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

Y Adja ◽

C Reno ◽

J Lenzi ◽

M P Fantini

Keyword(s):

Health Care ◽

Mortality Rate ◽

Health Services ◽

Health Inequalities ◽

Health Care Services ◽

Care Quality ◽

Amenable Mortality ◽

Care Services ◽

Italian Regions ◽

And Performance

Abstract Background Amenable mortality is an indicator that measures the extent to which health services contribute to the improvement of the health of a population. It can also highlight geographical and socioeconomic inequalities. Therefore, it is used to assess quality and performance of health care systems, both at national and subnational level. The Italian National Health Service sets the essential levels of care (Livelli Essenziali di Assistenza, LEA), a health-benefit package for all citizens. Because every region is responsible for providing the LEA and can offer additional health care, monitoring the performance of the Regional Health Services (RHSs) is of increasing interest. Methods We used Nolte and McKee's list of amenable conditions to analyze the temporal trend of the standardized mortality rate (per 100.000) in Italy from 2006 to 2015, overall and by gender. We also examined the standardized rate at regional level by comparing the two-year periods 2006/7 and 2014/5, overall and by gender. Results Between 2006 and 2015, the overall mortality rate decreased from 81 to 68 per 100.000 population; this reduction was more pronounced in men (91 to 76 per 100.000, -16.5%) than in women (72 to 62 per 100.000, -13.9%). The decreasing trend in amenable mortality affected Italian regions differently, with northern regions showing steeper reductions as compared to southern regions. As a result, 2014/5 was the first time men's mortality in North Italy (68 per 100.000) was lower than women's mortality in South Italy (72 per 100.000). Conclusions The overall reduction of amenable mortality shows that Italy's health care services keep contributing to the improvement of population health. Nevertheless, by analyzing RHS performance we saw that differences in organization of care lead to differences in health care quality and performance across regions. Deaths amenable to health care services contribute to inequalities between Northern and Southern Italy. Key messages Because universal health coverage is necessary but not sufficient to reduce health inequalities, investing into better-quality services should be recognized as a priority. Amenable mortality can highlight areas of intervention to reduce inequalities in the provision of health care services.

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Are the Poor Catching Up with the Rich in Utilising Maternal Health Care Services? Evidence from India

Journal of Health Management ◽

10.1177/09720634211035212 ◽

2021 ◽

Vol 23 (3) ◽

pp. 470-481

Author(s):

Sohini Paul

Keyword(s):

Health Care ◽

Maternal Health ◽

Health Services ◽

Health Care Services ◽

National Level ◽

Maternal Health Care ◽

Care Services ◽

The Poor ◽

Maternal Health Care Services ◽

The Rich

India launched the National Rural Health Mission (NRHM) in 2005 to improve maternal and child health by providing good quality health services to all, especially deprived sections of society, to reduce inequality in access to health services. With the backdrop of NRHM, we analysed the extent to which the utilisation of maternal health care services (MHCSs) in the three stages of the continuum of care—antenatal care (ANC), care during child delivery and postnatal care (PNC)—–has improved among the poor vis-à-vis the rich in India, and the corresponding narrowing down in inequality in the period 2006–2016. Data from the 3rd round of the National Family Health Survey (NFHS) in 2005–2006, capturing the pre-NRHM period and the 4th round of NFHS 2015–2016, capturing the post-NRHM era ten years after the implementation of the flagship programme, are used for the analysis. We estimated absolute as well as relative measures of inequality, absolute gap and coverage ratio between the poor and rich, slope index of inequality and concentration index. Our findings show that maternal health care coverage increased significantly among the poor for all components of MHCSs. Even so, the extent of utilisation of services remains significantly lower among the poor in 2015–2016 compared to the coverage among the rich in 2005–2006. Although inequality declined at the national level over the decade, it still persists. High equity has been achieved in using skilled birth attendance during child delivery and institutional delivery during 2015–2016, however, inequality continues to be higher for ANC indicators including consumption of iron and folic acid supplements for at least 100 days, receipt of four or more antenatal check-ups and comprehensive health check-ups at least once during antenatal visits and receipt of first check-up in the first trimester.

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Amenable mortality as a performance indicator of Italian health-care services

BMC Health Services Research ◽

10.1186/1472-6963-12-310 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 4

Author(s):

Maria P Fantini ◽

Jacopo Lenzi ◽

Giuseppe Franchino ◽

Cristina Raineri ◽

Alessandra Burgio ◽

...

Keyword(s):

Health Care ◽

Health Care Services ◽

Performance Indicator ◽

Amenable Mortality ◽

Care Services ◽

A Performance

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National Interest and European Law in the Legislation and Juridical Practice on Health Care Services – In the Light of the Reforms of the Hungarian Health Care System

Central European Public Administration Review ◽

10.17573/ipar.2015.1.07 ◽

2015 ◽

Vol 13 (1) ◽

pp. 135-158

Author(s):

István Hoffman

Keyword(s):

Health Care ◽

Public Service ◽

Health Care Services ◽

National Level ◽

National Interest ◽

Fundamental Rights ◽

Minor Importance ◽

Member States ◽

Care Services ◽

The Eu

The priority of the national interest in the field of the health care policy is secured by the rules of the TFEU, the Charter of Fundamental Rights of the European Union and by the secondary law as well. Although several market-type and pro-competitive solutions have appeared, they can have only limited influence on the national systems. The main reasons of the limited influence of the EU regulations are the primary responsibilities of the Member States, the widely applicable public health exceptions, and the limited application of the EU competition rules. Although the national legislation is the determinative, the EU regulations on the free movement of persons and services could be applied in the field of the health care services. This principle was recognized by the landmark decisions of the Court of Justice (ECJ). The Directive 2011/24/EU is based on these principles and a limited competition has evolved. Because the competition is limited and the creation of a single European health care area has just begun, the “silent revolution” of the public service provision has a minor importance. The practice of the ECJ has been focused on the use of the cross-border services and the Member States have had a broad margin for the organisation and management of this public service. The role of the European legislation on the competition is limited in this field as well. Therefore the strong centralization of the Hungarian health system from 2011 to 2013 may be in harmony with the EU legislation, although the competition at the national level is not promoted by the reformed Hungarian rules on health care.

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Trend Analysis of Vital Statistics in India - A Key to Improve Quality of Health Care Services and Infrastructure

International Journal of Research and Review ◽

10.52403/ijrr.20211129 ◽

2021 ◽

Vol 8 (11) ◽

pp. 217-226

Author(s):

Suganya. P ◽

Bharathwaj. V. V ◽

Sindhu. R

Keyword(s):

Health Care ◽

Mortality Rate ◽

Gross Domestic Product ◽

Trend Analysis ◽

Quality Of Health Care ◽

Death Rate ◽

Health Care Services ◽

Vital Statistics ◽

Care Services

Aim: The aim of this study is to assess the trends of vital statistics in India for improving the quality of health care services and infrastructure. Materials and Methods: This study was carried out to improve the quality of health care services and infrastructure by analysing the trends of vital statistics in India. The data regarding vital statistics which includes birth rate, death rate, infant mortality rate, neonatal mortality rate and total fertility rate were obtained from the year 2011-2017 using electronic sources such as sample registration system, National health profile and NITI Aayog. Results: The death rate found to be increased in various states and union territories of India. Over all the states and union territories in India Chhattisgarh, Madhya Pradesh, Odisha, Assam, Puducherry, Punjab and Uttar Pradesh has the highest death rate whereas the Nagaland, Chandigarh and Delhi has the lowest death rate. The rural areas of India have the highest number of mortality rate when compared to urban areas. Conclusion: The government of India should pay more attention to the health care services and increase the health care expenditure of the public from the Gross Domestic Product (GDP) for the beneficiaries of people. Keywords: Trend analysis, Vital statistics, India, Gross Domestic Product, Health care services, Infrastructure.

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