Avoidable mortality. Is it an indicator of quality of medical care in eastern European countries?

Abstract

Age-standardized time trends (1979-1988) for avoidable mortality in two Eastern European countries (Hungary and Czechoslovakia) and selected developed countries (England and Wales, France, Italy, Japan, Portugal and USA) have been analysed. Mortality from both all avoidable causes and all other causes declined in the selected developed countries during the period of observation, the decline in rates for avoidable causes was faster than that for all other causes. In Hungary and Czechoslovakia the death rates from both groups of causes increased in the first part of the period studied and a decline in mortality from both types of causes could be observed from 1985. As a consequence, the difference in avoidable mortality between the Eastern European countries and the developed countries increased by the end of the observation. Studies on mortality from individual amenable causes showed that the death rates are usually much higher in Hungary and Czechoslovakia than in the developed countries and the differences did not diminish during the period of study. In Hungary and Czechoslovakia the bad pattern of mortality from conditions amenable to medical interventions is believed to reflect, at least in part, the crisis in the health services which these countries have experienced for the past decades.