scholarly journals Patterns of amenable child mortality over time in 34 member countries of the Organisation for Economic Co-operation and Development (OECD): evidence from a 15-year time trend analysis (2001–2015)

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027909 ◽  
Author(s):  
Maria Michela Gianino ◽  
Jacopo Lenzi ◽  
Marco Bonaudo ◽  
Maria Pia Fantini ◽  
Roberta Siliquini ◽  
...  
Keyword(s):  
Trend Analysis ◽  
Child Mortality ◽  
Time Trend ◽  
Universal Access ◽  
Age Groups ◽  
Mortality Rates ◽  
Secondary Outcome ◽  
Annual Number ◽  
Amenable Mortality ◽  
Specific Distribution

ObjectivesTo analyse the trends of amenable mortality rates (AMRs) in children over the period 2001–2015.DesignTime trend analysis.SettingThirty-four member countries of the Organisation for Economic Co-operation and Development (OECD).ParticipantsMidyear estimates of the resident population aged ≤14 years.Primary and secondary outcome measuresUsing data from the WHO Mortality Database and Nolte and McKee’s list, AMRs were calculated as the annual number of deaths over the population/100 000 inhabitants. The rates were stratified by age groups (<1, 1–4, 5–9 and 10–14 years). All data were summarised by presenting the average rates for the years 2001/2005, 2006/2010 and 2011/2015.ResultsThere was a significant decline in children’s AMRs in the <1 year group in all 34 OECD countries from 2001/2005 to 2006/2010 (332.78 to 295.17/100 000; %Δ −11.30%; 95% CI −18.75% to −3.85%) and from 2006/2010 to 2011/2015 (295.17 to 240.22/100 000; %Δ −18.62%; 95% CI −26.53% to −10.70%) and a slow decline in the other age classes. The only cause of death that was significantly reduced was conditions originating in the early neonatal period for the <1 year group. The age-specific distribution of causes of death did not vary significantly over the study period.ConclusionsThe low decline in amenable mortality rates for children aged ≥1 year, the large variation in amenable mortality rates across countries and the insufficient success in reducing mortality from all causes suggest that the heath system should increase its efforts to enhance child survival. Promoting models of comanagement between primary care and subspecialty services, encouraging high-quality healthcare and knowledge, financing universal access to healthcare and adopting best practice guidelines might help reduce amenable child mortality.

scholarly journals Changing mortality trends in countries and cities of the UK: a population-based trend analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038135
Author(s):  
David Walsh ◽  
Gerry McCartney ◽  
Jon Minton ◽  
Jane Parkinson ◽  
Deborah Shipton ◽  
...  
Keyword(s):  
Trend Analysis ◽  
Causes Of Death ◽  
Age Groups ◽  
Mortality Rates ◽  
Population Based ◽  
Secondary Outcome ◽  
Mortality Trends ◽  
Relative Index ◽  
Index Of Inequality ◽  
The Uk

ObjectivesPreviously improving life expectancy and all-cause mortality in the UK has stalled since the early 2010s. National analyses have demonstrated changes in mortality rates for most age groups and causes of death, and with deprived populations most affected. The aims here were to establish whether similar changes have occurred across different parts of the UK (countries, cities), and to examine cause-specific trends in more detail.DesignPopulation-based trend analysis.Participants/settingWhole populations of countries and selected cities of the UK.Primary and secondary outcome measuresEuropean age-standardised mortality rates (calculated by cause of death, country, city, year (1981–2017), age group, sex and—for all countries and Scottish cities—deprivation quintiles); changes in rates between 5-year periods; summary measures of both relative (relative index of inequality) and absolute (slope index of inequality) inequalities.ResultsChanges in mortality from around 2011/2013 were observed throughout the UK for all adult age groups. For example, all-age female rates decreased by approximately 4%–6% during the 1980s and 1990s, approximately 7%–9% during the 2000s, but by <1% between 2011/2013 and 2015/2017. Equivalent figures for men were 4%–7%, 8%–12% and 1%–3%, respectively. This later period saw increased mortality among the most deprived populations, something observed in all countries and cities analysed, and for most causes of death: absolute and relative inequalities therefore increased. Although similar trends were seen across all parts of the UK, particular issues apply in Scotland, for example, higher and increasing drug-related mortality (with the highest rates observed in Dundee and Glasgow).ConclusionsThe study presents further evidence of changing mortality in the UK. The timing, geography and socioeconomic gradients associated with the changes appear to support suggestions that they may result, at least in part, from UK Government ‘austerity’ measures which have disproportionately affected the poorest.

scholarly journals Increasing emergency hospital activity in Denmark, 2005–2016: a nationwide descriptive study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e031409 ◽  
Author(s):  
Marianne Fløjstrup ◽  
Soren Bie Bogh ◽  
Daniel Pilsgaard Henriksen ◽  
Mickael Bech ◽  
Søren Paaske Johnsen ◽  
...  
Keyword(s):  
Regional Differences ◽  
Healthcare Reform ◽  
Age Groups ◽  
Descriptive Study ◽  
Acute Hospital ◽  
Secondary Outcome ◽  
Annual Number ◽  
Charlson Comorbidity Index Score ◽  
Time Of Arrival ◽  
Comorbidity Index

ObjectivesTo describe changes in unplanned acute activity and to identify and characterise unplanned contacts in hospitals in Denmark from 2005 to 2016, including following healthcare reform.DesignDescriptive study.SettingData from Danish nationwide registers.PopulationAdults (≥18 years).ParticipantsAll adults with an unplanned acute hospital contacts (acute inpatient admissions and emergency care visits) in Denmark from 2005 to 2016.Primary and secondary outcome measuresOutcomes were annual number of contacts, length of stay, number of contacts per 1000 citizen per year, age-adjusted contacts per 1000 citizens per year, sex, age groups, country of origin, Charlson Comorbidity Index score, discharge diagnosis and time of arrival.ResultsWe included a total of 13 524 680 contacts. The annual number of acute hospital contacts increased from 1 067 390 in 2005 to 1 221 601 in 2016. The number also increased with adjustment for age per 1000 citizens. In addition, regional differences were observed.ConclusionsUnplanned acute activity changed from 2005 to 2016. The national number of contacts increased, primarily because of changes in one of the five regions.

Child Mortality In The US And 19 OECD Comparator Nations: A 50-Year Time-Trend Analysis

2018 ◽  
Vol 37 (1) ◽  
pp. 140-149 ◽  
Author(s):  
Ashish P. Thakrar ◽  
Alexandra D. Forrest ◽  
Mitchell G. Maltenfort ◽  
Christopher B. Forrest
Keyword(s):  
Trend Analysis ◽  
Child Mortality ◽  
Time Trend ◽  
The Us

scholarly journals Use of amenable mortality indicators to evaluate the impact of financial crisis on health system performance in Greece

2020 ◽  
Vol 30 (5) ◽  
pp. 861-866 ◽  
Author(s):  
Christos Zilidis ◽  
David Stuckler ◽  
Martin McKee
Keyword(s):  
Health Care ◽  
Health System ◽  
System Performance ◽  
Age Groups ◽  
Mortality Rates ◽  
Medical Intervention ◽  
Health System Performance ◽  
Amenable Mortality ◽  
The Impact ◽  
Budget Reductions

Abstract Background Greece experienced the largest reduction in its health care budget of any European country during the economic crisis of 2008–15. Here, we test the hypothesis that budget reductions worsened health system performance in Greece, using the concept of Amenable Mortality to capture deaths which should not occur in the presence of effective and timely health care. Methods Amenable mortality was calculated from national mortality statistics, using age-standardized deaths from 34 conditions amenable to medical intervention in Greece during 2000–16, with further analysis by sex, age, region and cause. Mortality rate ratios and their 95% CI were also computed. Interrupted time series analyses were performed to compare trends prior to austerity measures (2001–10) with those after (2011–16), adjusting for historical trends. Results Prior to austerity measures, amenable mortality rates were declining. After 2011, coinciding with the inception of budget reductions, the slope of decline diminished significantly. The average annual percent of change in standardized death rates was 2.65% in 2001–10, falling to 1.60% in 2011–6. In 10 of 34 conditions, the SDR increased significantly after the crisis onset, and in five more conditions the long-term decline reversed, to increasing after 2011. The age-specific mortality rates observed in 2011–16 were significantly higher than those expected at ages 0–4 and 65–74 but not significantly higher in all other age groups. Conclusions Health system performance in Greece worsened in association with austerity measures, leading to a deceleration of the decline in amenable mortality and increased mortality from several conditions amenable to medical interventions.

scholarly journals A Bayesian spatio-temporal analysis of mortality rates in Spain: application to the COVID-19 2020 outbreak

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Pedro Saavedra ◽  
Angelo Santana ◽  
Luis Bello ◽  
José-Miguel Pacheco ◽  
Esther Sanjuán
Keyword(s):  
Time Trend ◽  
Age Groups ◽  
Specific Effect ◽  
Temporal Analysis ◽  
Mortality Rates ◽  
Temporal Models ◽  
Temporal Model ◽  
Spatio Temporal ◽  
The Impact ◽  
Excess Deaths

Abstract Background The number of deaths attributable to COVID-19 in Spain has been highly controversial since it is problematic to tell apart deaths having COVID as the main cause from those provoked by the aggravation by the viral infection of other underlying health problems. In addition, overburdening of health system led to an increase in mortality due to the scarcity of adequate medical care, at the same time confinement measures could have contributed to the decrease in mortality from certain causes. Our aim is to compare the number of deaths observed in 2020 with the projection for the same period obtained from a sequence of previous years. Thus, this computed mortality excess could be considered as the real impact of the COVID-19 on the mortality rates. Methods The population was split into four age groups, namely: (< 50; 50–64; 65–74; 75 and over). For each one, a projection of the death numbers for the year 2020, based on the interval 2008–2020, was estimated using a Bayesian spatio-temporal model. In each one, spatial, sex, and year effects were included. In addition, a specific effect of the year 2020 was added ("outbreak"). Finally, the excess deaths in year 2020 were estimated as the count of observed deaths minus those projected. Results The projected death number for 2020 was 426,970 people, the actual count being 499,104; thus, the total excess of deaths was 72,134. However, this increase was very unequally distributed over the Spanish regions. Conclusion Bayesian spatio-temporal models have proved to be a useful tool for estimating the impact of COVID-19 on mortality in Spain in 2020, making it possible to assess how the disease has affected different age groups accounting for effects of sex, spatial variation between regions and time trend over the last few years.

Inequalities and Impact of Socioeconomic-Cultural Factors in Suicide Rates Across Italy

Crisis ◽  
2011 ◽  
Vol 32 (4) ◽  
pp. 178-185 ◽  
Author(s):  
Maurizio Pompili ◽  
Marco Innamorati ◽  
Monica Vichi ◽  
Maria Masocco ◽  
Nicola Vanacore ◽  
...  
Keyword(s):  
Suicide Rate ◽  
Age Groups ◽  
Premature Death ◽  
Mortality Rates ◽  
Mortality Data ◽  
Italian Population ◽  
Comprehensive Overview ◽  
Suicide Rates ◽  
Younger Age ◽  
Age And Sex

Background: Suicide is a major cause of premature death in Italy and occurs at different rates in the various regions. Aims: The aim of the present study was to provide a comprehensive overview of suicide in the Italian population aged 15 years and older for the years 1980–2006. Methods: Mortality data were extracted from the Italian Mortality Database. Results: Mortality rates for suicide in Italy reached a peak in 1985 and declined thereafter. The different patterns observed by age and sex indicated that the decrease in the suicide rate in Italy was initially the result of declining rates in those aged 45+ while, from 1997 on, the decrease was attributable principally to a reduction in suicide rates among the younger age groups. It was found that socioeconomic factors underlined major differences in the suicide rate across regions. Conclusions: The present study confirmed that suicide is a multifaceted phenomenon that may be determined by an array of factors. Suicide prevention should, therefore, be targeted to identifiable high-risk sociocultural groups in each country.

Use of chemotherapy for early breast cancer in Germany, 2008-2017: A nationwide time-trend analysis

2020 ◽  
Author(s):  
F Riedel ◽  
AS Hoffmann ◽  
M Moderow ◽  
S Heublein ◽  
T Deutsch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Trend Analysis ◽  
Early Breast Cancer ◽  
Time Trend
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