Area variation in mortality from diseases amenable to medical intervention: the contribution of differences in morbidity.

Abstract:

:Several conditions, whose timely and appropriate therapy should decrease case fatality, have been proposed as indicators of medical care quality for the National Health Service. Mortality rates for these diseases vary widely within the UK. To evaluate the contribution of varying incidence rates to these mortality differences, routinely collected morbidity and mortality data for 1974-1978 were analysed for 98 Area Health Authorities (AHAs) in England and Wales. Although differences in morbidity (as measured by hospital discharge and disease registration rates) and socioeconomic factors account for some of the area variation in mortality, significant heterogeneity persists after these factors are taken into account. This finding suggests that morbidity and socioeconomic factors are not the only determinants of mortality variation among areas for these particular diseases. Variation in quality of medical care may account for this result, although regional diagnostic and reporting differences and variation in disease severity among areas must also be considered. :This study is concerned with variations in mortality from diseases amenable to medical intervention in England and Wales. The focus is on the extent to which these variations can be used to evaluate the quality of medical care provided by the National Health Service. The data concern 98 Area Health Authorities and are for the period 1974-1978. The results suggest that differences in morbidity and socioeconomic factors are not the only determinants of mortality and that variations in the quality of health care may also be relevant factors.

journal_name

Int J Epidemiol

authors

Bauer RL,Charlton JR

doi

10.1093/ije/15.3.408

subject

Has Abstract

pub_date

1986-09-01 00:00:00

pages

408-12

issue

3

eissn

0300-5771

issn

1464-3685

journal_volume

15

pub_type

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