Avoidable Mortality Differences between Rural and Urban Residents During 2004–2011: A Case Study in Iran

Abstract

Background: Avoidable mortality as an indicator for assessing the health system performance has caught the attention of researchers for a long time. In this study we aimed to compare the health system performance using this indicator in rural and urban areas of one of Iran's southern provinces. Methods: All deaths (29916) which happened during 2004-2011 in Bushehr province were assessed. Nolte and McKee's avoidable deaths model was used to distinguish avoidable and unavoidable conditions. Accordingly, all deaths were classified into four categories including three avoidable death categories and one unavoidable death category. STATA software was used to conduct Poisson Regression Test and agestandardized death rate. Results: Findings showed that avoidable mortality rates declined in both urban and rural areas at 3.33% per year, but decline rates were influenced by Ischemic Heart Disease (IHD) and preventable death categories to treatable death category. Annual decline rate for IHD category in rural and urban areas was nearly the same as 8%, but in preventable death category, rural areas experienced more decreases than urban ones (7% vs 5% respectively). However, decline rate in treatable mortality neither in urban and nor in rural areas was statistically significant. Conclusion: Despite the annual decline in the rate of avoidable deaths, policy making initiatives especially screening and inter-sectoral measures targeting cause of deaths such as colon and breast cancers, hypertension, lung cancer and traffic accidents, can still further decrease avoidable deaths in both areas.

Avoidable Mortality between Metropolitan and Non-Metropolitan Areas in Korea from 1995 to 2019: A Descriptive Study of Implications for the National Healthcare Policy

“…Moreover, recently, inequality levels had increased in both sexes. The inequality of treatable death is influenced by regional material deprivation levels and the unequal distribution of medical resources, such as the number of beds or physicians across the regions [ 3 , 9 , 13 ]. Through the Korean National Health Insurance System, the policy for universal health coverage contributed to the improvement of personal medical expenses.…”

“…Avoidable death refers to death from preventable or treatable causes and has been used as an indicator to evaluate the effectiveness of health promotion policies, such as smoking cessation, alcohol consumption, and healthcare systems [ 9 , 10 ]. In addition, avoidable deaths can be used to identify areas with high healthcare needs and reflect differences in healthcare access in health inequality studies [ 11 , 12 , 13 , 14 ]. Causes of death included in avoidable deaths are continuously changing in consideration of the characteristics of each country and the development of medical technology.…”

“…Bahk and Jung-Choi (2020) established a study on the differences in life expectancy of avoidable deaths by age group [ 2 ]. In addition, a comparative study targeting the European countries and areas such as urban or rural areas within the country was also conducted [ 9 , 12 , 13 , 17 , 18 , 19 ]. However, to the best of our knowledge, there are no studies on the inequality in avoidable deaths between metropolitan and non-metropolitan areas in Korea.…”

Economic Burden of Hospitalized COVID-19 Patients in Iran

“…The economic burden of COVID -19 exceeds the direct medical costs and extends to the indirect costs, especially premature deaths costs and costs of absenteeism [13][14][15]. lost productivity araised from the premature death with regard to the fatality rate of COVID- 19 [16] and conducted studies about premature deaths rate [17] is estimated to be high. The calculation of the economic burden of the disease has been studied in several studies [6,18,19].…”

Untimely applause was a distraction Comment on "Shanghai rising: health improvements as measured by avoidable mortality since 2000"

“…Surprisingly, with a relatively high level of avoidable mortality in the early year, and approximately 50% decline in deaths from coronary heart disease from 1980 through 2000 (5), the United States (U.S) experienced a much smaller reduction of avoidable mortality during the same period according to Nolte et al (6). The term of avoidable mortality has been used by the World Health Organization (WHO) (7), and researchers in many countries (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21), mainly the countries of Organization for Economic Co-operation and Development (OECD). In spite of a steady increase in the number of publications using the term of avoidable mortality since the late 1980s, little progress has been made in advancing the original concept, critically limiting its' acceptability among health serve research community (4,22).…”