32 results
Search Results
2. The impact of eliminating age inequalities in stage at diagnosis on breast cancer survival for older women
- Author
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David Greenberg, Paul C. Lambert, Georgios Lyratzopoulos, Mark J. Rutherford, Gary A. Abel, Lyratzopoulos, Georgios [0000-0002-2873-7421], and Apollo - University of Cambridge Repository
- Subjects
Cancer Research ,medicine.medical_specialty ,age inequalities ,Population ,excess mortality models ,Breast Neoplasms ,Cohort Studies ,Breast cancer ,avoidable deaths ,medicine ,Humans ,Healthcare Disparities ,education ,Survival rate ,Aged ,Aged, 80 and over ,Cervical cancer ,Gynecology ,education.field_of_study ,Full Paper ,Relative survival ,business.industry ,Carcinoma, Ductal, Breast ,Age Factors ,Health Status Disparities ,medicine.disease ,Survival Rate ,Carcinoma, Lobular ,England ,Socioeconomic Factors ,Oncology ,Cohort ,Female ,Skin cancer ,business ,Demography ,Cohort study - Abstract
Background: Older women with breast cancer have poorer relative survival outcomes, but whether achieving earlier stage at diagnosis would translate to substantial reductions in mortality is uncertain. Methods: We analysed data on East of England women with breast cancer (2006–2010) aged 70+ years. We estimated survival for different stage-deprivation-age group strata using both the observed and a hypothetical stage distribution (assuming that all women aged 75+ years acquired the stage distribution of those aged 70–74 years). We subsequently estimated deaths that could be postponed beyond 5 years from diagnosis if women aged 75+ years had the hypothetical stage distribution. We projected findings to the English population using appropriate age and socioeconomic group weights. Results: For a typically sized annual cohort in the East of England, 27 deaths in women with breast cancer aged 75+ years can be postponed within 5 years from diagnosis if their stage distribution matched that of the women aged 70–74 years (4.8% of all 566 deaths within 5 years post diagnosis in this population). Under assumptions, we estimate that the respective number for England would be 280 deaths (5.0% of all deaths within 5 years post diagnosis in this population). Conclusions: The findings support ongoing development of targeted campaigns aimed at encouraging prompt presentation in older women.
- Published
- 2015
3. The size of the prize for earlier diagnosis of cancer in England
- Author
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Michael Richards
- Subjects
Discussion Paper ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Colorectal cancer ,medicine.medical_treatment ,MEDLINE ,late diagnosis ,Breast Neoplasms ,colorectal cancer ,breast cancer ,Breast cancer ,Neoplasms ,Intervention (counseling) ,avoidable deaths ,medicine ,Humans ,Lung cancer ,Intensive care medicine ,Early Detection of Cancer ,Gynecology ,business.industry ,Public health ,Cancer ,medicine.disease ,Radiation therapy ,lung cancer ,England ,Oncology ,Female ,Colorectal Neoplasms ,business - Abstract
Background: This supplement presents a wide range of observations, reviews, novel research and analyses underpinning the National Awareness and Early Diagnosis Initiative (NAEDI). The preceding three papers present and discuss different aspects of the data from European cancer survival comparison studies. I conclude here by attempting to quantify the extent to which delayed diagnosis in England accounts for observed survival differences and by outlining areas for further research. Methods: Analysis of indirect evidence related to late diagnosis, surgical intervention rates and utilisation of radiotherapy and chemotherapy in England and other European countries in the late 1990s for breast, colorectal and lung cancer. Results: Late diagnosis was almost certainly a major contributor to poor survival in England for all three cancers. Low surgical intervention rates are very likely to have contributed to low survival rates for lung cancer and possibly for the other two cancers. Any differences in the use of radiotherapy or chemotherapy are likely to have had only a minor impact on survival differences. Conclusion: Between 5000 and 10000 deaths within 5 years of diagnosis could be avoided every year in England if efforts to promote earlier diagnosis and appropriate primary surgical treatment are successful. Detailed international benchmarking studies are to be recommended.
- Published
- 2009
4. Estimating the potential survival gains by eliminating socioeconomic and sex inequalities in stage at diagnosis of melanoma
- Author
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N Ormiston-Smith, L. Ironmonger, Gary A. Abel, David Greenberg, Georgios Lyratzopoulos, Mark J. Rutherford, Paul C. Lambert, Lyratzopoulos, Georgios [0000-0002-2873-7421], and Apollo - University of Cambridge Repository
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Skin Neoplasms ,Inequality ,sex inequalities ,media_common.quotation_subject ,excess mortality models ,Disease ,Social class ,Breast cancer ,Sex Factors ,medicine ,avoidable deaths ,Humans ,Healthcare Disparities ,Mortality ,neoplasms ,Socioeconomic status ,Survival rate ,Melanoma ,media_common ,Aged ,Neoplasm Staging ,Cervical cancer ,Aged, 80 and over ,Models, Statistical ,Full Paper ,socioeconomic inequalities ,business.industry ,Health Status Disparities ,Middle Aged ,medicine.disease ,Surgery ,Survival Rate ,Oncology ,England ,Social Class ,Socioeconomic Factors ,Female ,Skin cancer ,business ,Demography - Abstract
BACKGROUND: Although inequalities in cancer survival are thought to reflect inequalities in stage at diagnosis, little evidence exists about the size of potential survival gains from eliminating inequalities in stage at diagnosis. METHODS: We used data on patients diagnosed with malignant melanoma in the East of England (2006-2010) to estimate the number of deaths that could be postponed by completely eliminating socioeconomic and sex differences in stage at diagnosis after fitting a flexible parametric excess mortality model. RESULTS: Stage was a strong predictor of survival. There were pronounced socioeconomic and sex inequalities in the proportion of patients diagnosed at stages III-IV (12 and 8% for least deprived men and women and 25 and 18% for most deprived men and women, respectively). For an annual cohort of 1025 incident cases in the East of England, eliminating sex and deprivation differences in stage at diagnosis would postpone approximately 24 deaths to beyond 5 years from diagnosis. Using appropriate weighting, the equivalent estimate for England would be around 215 deaths, representing 11% of all deaths observed within 5 years from diagnosis in this population. CONCLUSIONS: Reducing socioeconomic and sex inequalities in stage at diagnosis would result in substantial reductions in deaths within 5 years of a melanoma diagnosis.
- Published
- 2015
5. Measuring Health Inequality with Realization of Conditional Potential Life Years (RCPLY).
- Author
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Petrie, Dennis, Tang, Kam, and Rao, D.
- Subjects
HEALTH behavior ,LONGEVITY ,LIFE spans ,HEALTH self-care ,MORTALITY - Abstract
Health inequalities that are avoidable and unfair are considered more relevant for policy intervention. Recent work has improved on using life years (LY) to measure longevity inequality by developing a health indicator-the Realization of Potential Life Years (RePLY)-to adjust for unavoidable mortality risks. This approach, however, estimates unavoidable mortality risks by using the globally lowest mortality risks for each age-sex group of any country, and thus, benchmarking countries at different levels of development against the same unavoidable mortality risks without considering their heterogeneity. The current paper proposes to attempt to control for a country's national resources in estimating their (conditional) avoidable mortality risks. This allows the construction of a new health indicator-Realization of Conditional Potential Life Years (RCPLY). This paper presents and contrasts the empirical results for LY, RePLY and RCPLY based on life tables for 136 countries from the year 2009. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
6. The National Awareness and Early Diagnosis Initiative in England: assembling the evidence.
- Author
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Richards, M. A.
- Subjects
CANCER diagnosis ,MEDICAL screening ,TUMOR markers ,DISEASE management ,DECISION making in clinical medicine - Abstract
A National Awareness and Early Diagnosis Initiative (NAEDI) has been established in England as part of the Government's strategy to improve cancer outcomes. One of the early priorities for this initiative has been to assemble the diverse evidence linking late diagnosis with poor survival and avoidable deaths. This supplement brings together new perspectives on existing research in this area together with findings from recently commissioned research. This paper describes a provisional model, the 'NAEDI pathway', for testing hypotheses relating to late diagnosis and its impact. Key findings from other papers in this supplement are also highlighted. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
7. Determinants of avoidable deaths from ischemic heart disease in East and West Germany.
- Author
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Schwierz, Christoph and Wübker, Ansgar
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CORONARY disease ,CATHETERS ,CATHETERIZATION ,MORTALITY ,PUBLIC health research - Abstract
Within Germany, a significant decrease in avoidable mortality from ischemic heart disease (IHD) has been observed since the early 1990s. The objective of this paper is to identify the specific reasons that have led to the decrease in the number of avoidable deaths from IHD in West and East Germany from 1996 to 2004. We analyzed the mortality rate from IHD of the male population aged less than 65 years on the regional level of German counties over the 1996–2004 period. Methodologically, after adjusting for a number of health structure variables, the socioeconomic structure of each region, and yearly time trends in avoidable mortality, we accounted for unobservable differences among regions by using a fixed-effect estimator. Our main result reveals that the number of intracardiac catheter facilities, an important diagnostic tool for IHD, significantly accounts for decreases in avoidable mortality from IHD. This is important, as the modernization of the East German health sector included a considerable catching-up process in the number of IC facilities provided relative to West Germany. Our results suggest that the modernization of the East German health sector may have contributed to saving people from premature deaths. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
8. Educational inequalities in avoidable deaths in Norway: A population based study.
- Author
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Dahl, Espen, Hofoss, Dag, and Elstad, Jon Ivar
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MORTALITY ,HEART disease related mortality ,CAUSES of death ,HEALTH policy ,MEDICAL care - Abstract
The question we raise in this paper is whether the educational gradient in avoidable mortality differs from overall and non-avoidable mortality among men and women in Norway. By avoidable deaths we refer to deaths caused by diseases that are either treatable if given appropriate medical care, or preventable if available preventive measures were implemented. The data set is derived from official administrative registers and includes all Norwegian men (1 107 427) and women (1 087 842) aged 25-67 years with information about status alive/dead during the period 1994-1999. Adjusted for sociodemographic and socioeconomic factors, education forms a marked and independent gradient in overall and non-avoidable mortality and an even steeper gradient in avoidable mortality - in particular in ischemic heart disease and preventable deaths. The educational gradient is shallower for deaths considered treatable by health care, but is still present. These patterns apply to men and women alike. The findings of our study suggest that health care and health policies may play a role in reducing inequalities in deaths that are 'avoidable, unnecessary and unjust'. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
9. AVOIDABLE DEATHS TENDENCY IN ROMANIA.
- Author
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CUCU, ALEXANDRA, DOMNARIU, CARMEN DANIELA, GALAN, ADRIANA, CHIRIȚĂ, CRISTINA, and TOADER, OANA
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MEDICAL care ,MORTALITY ,ECONOMIC efficiency ,PHYSICIANS' attitudes ,POPULATION health ,HEALTH status indicators - Abstract
Copyright of Acta Medica Transilvanica is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2014
10. TENDINȚA DECESELOR EVITABILE ÎN ROMÂNIA.
- Author
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CUCU, ALEXANDRA, DOMNARIU, CARMEN DANIELA, GALAN, ADRIANA, CHIRIȚĂ, CRISTINA, and TOADER, OANA
- Abstract
Copyright of Acta Medica Transilvanica is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2014
11. The size of the prize for earlier diagnosis of cancer in England.
- Author
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Richards, M. A.
- Subjects
COLON cancer ,LUNG cancer ,BREAST cancer ,RADIOTHERAPY ,DRUG therapy - Abstract
Background: This supplement presents a wide range of observations, reviews, novel research and analyses underpinning the National Awareness and Early Diagnosis Initiative (NAEDI). The preceding three papers present and discuss different aspects of the data from European cancer survival comparison studies. I conclude here by attempting to quantify the extent to which delayed diagnosis in England accounts for observed survival differences and by outlining areas for further research.Methods: Analysis of indirect evidence related to late diagnosis, surgical intervention rates and utilisation of radiotherapy and chemotherapy in England and other European countries in the late 1990s for breast, colorectal and lung cancer.Results: Late diagnosis was almost certainly a major contributor to poor survival in England for all three cancers. Low surgical intervention rates are very likely to have contributed to low survival rates for lung cancer and possibly for the other two cancers. Any differences in the use of radiotherapy or chemotherapy are likely to have had only a minor impact on survival differences.Conclusion: Between 5000 and 10000 deaths within 5 years of diagnosis could be avoided every year in England if efforts to promote earlier diagnosis and appropriate primary surgical treatment are successful. Detailed international benchmarking studies are to be recommended. [ABSTRACT FROM AUTHOR]- Published
- 2009
- Full Text
- View/download PDF
12. Modelling Determinants of Deaths Attributable to External Causes Among Adults in India.
- Author
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Sil, Apyayee, Sil, Arpan, and Dhillon, Preeti
- Subjects
MORTALITY risk factors ,CAUSES of death ,RISK assessment ,SURVEYS ,POISSON distribution ,ADULTS - Abstract
The study aimed at finding the risk factors associated with adult mortality (15–59 years) due to external causes (accidents, suicide, poisoning, homicide, and violence). Using National Family Health Survey data-4 consisting of 1,756,867 sample, we applied a Robust Poisson Regression Model to determine the potential risk factors. Findings suggest that the highest proportion of deaths due to external causes was in the age group 20–24 years. The prevalence of these deaths was higher among older adults (age 50 years and above). The risk was more among males (Incident Rate Ratio (IRR) for females is: 0.29, p < 0.001), rural residents (IRR: 1.16, p < 0.001), exposed to mass-media (IRR: 1.08, p < 0.05), residing in female-headed households, in households having a member with higher education. This risk decreased for large families (IRR: 0.89, p <.001). A need to strengthen awareness and mentorship programs for young-adults and middle-aged people to control such avoidable deaths is recommended. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
13. Quantifying the absolute number of cancer deaths that would be avoided if cancers were diagnosed prior to progressing to distant metastasis, New South Wales, Australia 1985‐2014.
- Author
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Yu, Xue Qin, Dasgupta, Paramita, and Baade, Peter
- Subjects
CANCER diagnosis ,SURVIVAL analysis (Biometry) ,TUMOR classification ,CANCER-related mortality ,METASTASIS - Abstract
Our study measures the impact of diagnosing cancers early before they metastasise on reducing the burden of cancer death. A cohort of 716 501 people aged 15 to 89 years diagnosed with a solid cancer in New South Wales, Australia, during 1985 to 2014 were followed‐up to December 2015. Crude probabilities of cancer death by stage at diagnosis were calculated for all solid cancers combined and five individual cancers using flexible parametric relative survival models. These probabilities were used to estimate the number of avoided cancer deaths within 10 years of diagnosis in three 10‐year diagnostic periods if all cases with known distant stage were instead diagnosed at an earlier stage. Cancers are known to be diagnosed at distant stage composed ~16% of all solid cancers diagnosed during 2005 to 2014. Assuming all these cases were instead diagnosed at regional stage, an annual average of 2064 cancer deaths would have been potentially avoided within 10 years of diagnosis. This equated to ~21% of modelled observed deaths. Alternatively, if half of all known distant cases diagnosed during 2005 to 2014 were diagnosed as regional and half as localised, the average number of deaths avoided per year would increase to 2677 (~28%). Estimates varied by diagnostic period, sex and cancer type, reflecting both the different stage distributions for the cancer types, and the respective survival differences between cancer stages. While prevention is the most effective pillar of cancer control, these findings quantify the potential benefits of diagnosing all cancer types when they are less advanced to reduce the burden of cancer mortality. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
14. Avoidable mortality risks and measurement of wellbeing and inequality
- Author
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Tang, Kam Ki, Chin, Jackie T.C., and Rao, D.S. Prasada
- Subjects
- *
MORTALITY , *LIFE expectancy , *MEDICAL economics , *WELL-being , *EQUALITY , *SUDDEN death - Abstract
This paper proposes a data envelopment method to separate avoidable and unavoidable mortality risks. As unavoidable mortality is either beyond the control of humanity or likely to be very cost-ineffective to reduce in the short to medium term, avoidable mortality is of much greater practical relevance in measuring wellbeing and inequality. The new method is applied to a dataset consisting of life tables for 191 countries in the year 2000 to obtain a reference distribution of unavoidable mortality risks. The reference distribution is used to improve on the standard age-at-death measure to obtain an age-at-avoidable-death measure. Compared with the standard measure, age-at-avoidable-death provides a very different picture of wellbeing, and more so when it comes to inequality measures. [Copyright &y& Elsevier]
- Published
- 2008
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15. Is current body temperature measurement practice fit-for-purpose?
- Author
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Machin, Graham, Brettle, David, Fleming, Susannah, Nutbrown, Rebecca, Simpson, Rob, Stevens, Richard, and Tooley, Mark
- Subjects
BODY temperature regulation ,MEDICAL thermometers ,COVID-19 pandemic ,DRUG resistance in bacteria ,INFRARED imaging - Abstract
There has been a marked rise in the number of avoidable deaths in health services around the world. At the same time there has been a growing increase in antibiotic resistant so-called "superbugs." We examine here the potential role of body temperature measurement in these adverse trends. Electronic based thermometers have replaced traditional mercury (and other liquid-in-glass type) thermometers for reasons of safety rather than superiority. Electronic thermometers are in general less robust from a measurement perspective than their predecessors. We illustrate the implications of unreliable temperature measurement on the diagnosis and management of disease, including COVID-19, through statistical calculations. Since a return to mercury thermometers is both undesirable and impractical, we call for better governance in the current practice of clinical thermometry to ensure the traceability and long-term accuracy of electronic thermometers and discuss how this could be achieved. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
16. Patterns of mortality among adults with intellectual and developmental disabilities in the Canadian province of Manitoba.
- Author
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Shooshtari, Shahin, Ouellette‐Kuntz, Hélène, Balogh, Robert, McIsaac, Michael, Stankiewicz, Elizabeth, Dik, Natalia, and Burchill, Charles
- Subjects
AGE distribution ,COMPARATIVE studies ,CAUSES of death ,DEVELOPMENTAL disabilities ,PEOPLE with intellectual disabilities ,CASE-control method ,DESCRIPTIVE statistics - Abstract
Objectives: The goals of this study were to examine and compare (a) the annual adult mortality rates and (b) the most commonly reported underlying causes of death between a cohort of Manitobans with intellectual and developmental disabilities (IDD) and a matched comparison group without IDD. Methods: Using linked health and nonhealth administrative data, a cohort of Manitoba adults with IDD, aged 25–99 years in 2012, was identified. Each person in the study cohort was matched with three persons without IDD based on age, sex, region of residence, and morbidity level. The two groups were followed for three years (2013–2015). Crude annual adult mortality rates and avoidable premature mortality rates were calculated. The leading causes of death over the 3‐year study period were tabulated by ICD‐10 chapter. Coding of the underlying causes of death was reviewed. Results: The crude annual mortality rates for Manitoba adults with IDD were 1.8–2.4 times higher than those for the matched comparison group and remained stable over time. Disparities in mortality rates for the IDD cohort relative to the matched comparison group decreased with increasing age. No significant sex differences were found. The leading causes of death among the IDD cohort were diseases of the circulatory system, cancer, and diseases of the respiratory system. Avoidable premature deaths were 2.3–3.3 times more prevalent among Manitoba adults with IDD compared to the matched comparison group. An IDD diagnostic code was reported as cause of death in 2.11% of cases. Conclusions: The excess mortality among adults with IDD should be monitored in Manitoba and all other jurisdictions and attention paid to the causes of death and their coding. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
17. The contributions of public health policies and healthcare quality to gender gap and country differences in life expectancy in the UK
- Author
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Allel, Kasim, Salustri, Franceso, Haghparast-Bidgoli, Hassan, and Kiadaliri, Ali
- Published
- 2021
- Full Text
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18. Marginal measures and causal effects using the relative survival framework.
- Author
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Syriopoulou, Elisavet, Rutherford, Mark J, and Lambert, Paul C
- Subjects
CANCER patients ,COLON (Anatomy) ,ETIOLOGY of cancer ,CAUSES of death ,CANCER prognosis ,COLON tumors ,RESEARCH ,RESEARCH methodology ,PROGNOSIS ,MEDICAL cooperation ,EVALUATION research ,COMPARATIVE studies ,SURVIVAL analysis (Biometry) ,SOCIAL classes ,RESEARCH funding ,PROBABILITY theory - Abstract
Background: In population-based cancer survival studies, the event of interest is usually death due to cancer. However, other competing events may be present. Relative survival is a commonly used measure in cancer studies that circumvents problems caused by the inaccuracy of the cause of death information. A summary of the prognosis of the cancer population and potential differences between subgroups can be obtained using marginal estimates of relative survival.Methods: We utilize regression standardization to obtain marginal estimates of interest in a relative survival framework. Such measures include the standardized relative survival, standardized all-cause survival and standardized crude probabilities of death. Contrasts of these can be formed to explore differences between exposure groups and under certain assumptions are interpreted as causal effects. The difference in standardized all-cause survival can also provide an estimate for the impact of eliminating cancer-related differences between exposure groups. The potential avoidable deaths after such hypothetical scenarios can also be estimated. To illustrate the methods we use the example of survival differences across socio-economic groups for colon cancer.Results: Using relative survival, a range of marginal measures and contrasts were estimated. For these measures we either focused on cancer-related differences only or chose to incorporate both cancer and other cause differences. The impact of eliminating differences between groups was also estimated. Another useful way for quantifying that impact is the avoidable deaths under hypothetical scenarios.Conclusions: Marginal estimates within the relative survival framework provide useful summary measures and can be applied to better understand differences across exposure groups. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
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19. Potentially Avertable Premature Deaths Associated with Jail Incarceration in New York City
- Author
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Reilly, Kathleen H., Johns, Eileen, Noyan, Nebahat, Schretzman, Maryanne, and Tsao, Tsu-Yu
- Published
- 2019
- Full Text
- View/download PDF
20. The National Awareness and Early Diagnosis Initiative in England: assembling the evidence
- Author
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Michael Richards
- Subjects
Cancer Research ,Medical education ,medicine.medical_specialty ,Government ,Introduction ,business.industry ,Public health ,cancer awareness ,MEDLINE ,survival ,Health promotion ,Oncology ,Late diagnosis ,England ,Environmental health ,medicine ,avoidable deaths ,Humans ,business ,Early Detection of Cancer ,early diagnosis - Abstract
A National Awareness and Early Diagnosis Initiative (NAEDI) has been established in England as part of the Government's strategy to improve cancer outcomes. One of the early priorities for this initiative has been to assemble the diverse evidence linking late diagnosis with poor survival and avoidable deaths. This supplement brings together new perspectives on existing research in this area together with findings from recently commissioned research. This paper describes a provisional model, the 'NAEDI pathway', for testing hypotheses relating to late diagnosis and its impact. Key findings from other papers in this supplement are also highlighted.
- Published
- 2009
21. Benefit of hindsight: systematic analysis of coronial inquest data to inform patient safety in hospitals
- Author
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Carol Grech, Val Pudney, Pudney, Val, and Grech, Carol
- Subjects
Male ,longitudinal data ,Pediatrics ,medicine.medical_specialty ,Population health ,systematic analysis ,Coroner ,03 medical and health sciences ,Patient safety ,0302 clinical medicine ,Risk Factors ,Cause of Death ,Acute care ,South Australia ,coroner ,Health care ,avoidable deaths ,Humans ,Medicine ,Hospital Mortality ,030212 general & internal medicine ,Retrospective Studies ,Inquest ,Health economics ,business.industry ,Health Policy ,Public health ,030208 emergency & critical care medicine ,practitioner education ,Hospitals ,Family medicine ,Female ,Patient Safety ,acute care ,business ,Coroners and Medical Examiners - Abstract
Objective The aim of the present study was to explore the potential of coronial inquest data to inform patient safety improvement in hospitals at a system level. Methods A retrospective analysis of 20 years of South Australian (SA) coronial inquest findings was performed using both qualitative content analysis methods and statistical descriptive analyses. Results In all, 113 cases were analysed. More than one-third of deaths (39%) were associated with emergency care. Analysis revealed 11 recurrent themes and two notable contributing factors that highlighted specific areas of concern for SA hospitals over that time period. The most common action recommended by coroners (49.6%; n = 56 cases) was the review or development of policy, protocol, procedure or guidelines designed to improve patient care. In almost one-quarter (24%) of deaths reviewed, coroners alerted health authorities to poor standards of care and/or instructed individual clinicians to review the standard of their clinical practice. Conclusions The analysis provided a retrospective review of coronial inquest data associated with hospital care over a 20-year period. The findings highlight specific areas of concern for patient safety over that time. More broadly, this analysis contributes to an emerging body of evidence in the Australian academic literature that demonstrates the value of systematic analysis of coronial data at a system level to inform patient safety improvement in Australian healthcare. What is known about the topic? Australian coroners have an important role to play in public health and safety. Many areas of social inquiry across Australia use coronial inquest data to identify recurrent hazards and assist in the development of relevant social policy. However, there is very little research reported in the academic literature that associates analyses of coronial data with patient safety improvement in healthcare. Although coronial recommendations made from individual cases of avoidable death are considered by health authorities, there is no evidence in the academic or grey literature that any systematic analysis of coronial inquest data is undertaken at a national or state or territory level to contribute to patient safety improvement. The few cases that are reported in the Australian academic literature provide valuable evidence of the benefits in terms of identifying recurrent hazards and prompting practice change. What does this paper add? This paper provides a descriptive overview of 20 years of coronial inquest data associated with hospital care in one Australian state. It provides evidence of recurrent themes and noteworthy contributing factors that highlight specific areas of concern for patient safety in hospitals. The methods used in the analysis can be applied across other settings in Australian healthcare. In addition, the paper adds to an emerging body of research evidence in the Australian academic literature illustrating the benefits of reviewing coronial inquest data to inform patient safety initiatives. What are the implications for practitioners? Findings from this analysis can be used to further the knowledge and understanding of health practitioners working in hospital settings as to the type of patients, clinical incidents and medical management issues that have featured repeatedly in avoidable deaths reported by coroners.
- Published
- 2016
22. Benefit of hindsight: systematic analysis of coronial inquest data to inform patient safety in hospitals.
- Author
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Pudney, Val and Grech, Carol
- Subjects
CONTENT analysis ,CORONERS ,CAUSES of death ,EMERGENCY medical services ,FACTOR analysis ,PATIENT safety ,QUALITY assurance ,URBAN hospitals ,SYSTEMATIC reviews ,THEMATIC analysis ,RETROSPECTIVE studies ,DATA analysis software ,DESCRIPTIVE statistics ,HOSPITAL mortality - Abstract
Objective. The aim of the present study was to explore the potential of coronial inquest data to inform patient safety improvement in hospitals at a system level. Methods. A retrospective analysis of 20 years of South Australian (SA) coronial inquest findings was performed using both qualitative content analysis methods and statistical descriptive analyses. Results. In all, 113 cases were analysed. More than one-third of deaths (39%) were associated with emergency care. Analysis revealed 11 recurrent themes and two notable contributing factors that highlighted specific areas of concern for SA hospitals over that time period. The most common action recommended by coroners (49.6%; n = 56 cases) was the review or development of policy, protocol, procedure or guidelines designed to improve patient care. In almost one-quarter (24%) of deaths reviewed, coroners alerted health authorities to poor standards of care and/or instructed individual clinicians to review the standard of their clinical practice. Conclusions. The analysis provided a retrospective review of coronial inquest data associated with hospital care over a 20-year period. The findings highlight specific areas of concern for patient safety over that time. More broadly, this analysis contributes to an emerging body of evidence in the Australian academic literature that demonstrates the value of systematic analysis of coronial data at a system level to inform patient safety improvement in Australian healthcare. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
23. Educational differentials in cancer mortality and avoidable deaths in Lithuania, 2001–2009: a census-linked study
- Author
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Jasilionis, Domantas, Smailyte, Giedre, Vincerzevskiene, Ieva, and Shkolnikov, Vladimir M.
- Published
- 2015
- Full Text
- View/download PDF
24. Socioeconomic differences in mortality amenable to health care among Finnish adults 1992-2003: 12 year follow up using individual level linked population register data.
- Author
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McCallum, Alison K., Manderbacka, Kristiina, Arffman, Martti, Leyland, Alastair H., and Keskimäki, Ilmo
- Subjects
SOCIOECONOMICS ,MEDICAL care ,FOLLOW-up studies (Medicine) ,CAUSES of death ,NINETEEN nineties - Abstract
Background: Finland decentralised its universal healthcare system and introduced market reforms in the 1990s. Despite a commitment to equity, previous studies have identified persistent socio-economic inequities in healthcare, with patterns of service use that are more pro-rich than in most other European countries. To examine whether similar socio-economic patterning existed for mortality amenable to intervention in primary or specialist care, we investigated trends in amenable mortality by income group from 1992-2003. Methods: We analysed trends in all cause, total disease and mortality amenable to health care using individual level data from the National Causes of Death Register for those aged 25 to 74 years in 1992-2003. These data were linked to sociodemographic data for 1990-2002 from population registers using unique personal identifiers. We examined trends in causes of death amenable to intervention in primary or specialist healthcare by income quintiles. Results: Between 1992 and 2003, amenable mortality fell from 93 to 64 per 100,000 in men and 74 to 54 per 100,000 in women, an average annual decrease in amenable mortality of 3.6% and 3.1% respectively. Over this period, all cause mortality declined less, by 2.8% in men and 2.5% in women. By 2002-2003, amenable mortality among men in the highest income group had halved, but the socioeconomic gradient had increased as amenable mortality reduced at a significantly slower rate for men and women in the lowest income quintile. Compared to men and women in the highest income quintile, the risk ratio for mortality amenable to primary care had increased to 14.0 and 20.5 respectively, and to 8.8 and 9.36 for mortality amenable to specialist care. Conclusions: Our findings demonstrate an increasing socioeconomic gradient in mortality amenable to intervention in primary and specialist care. This is consistent with the existing evidence of inequity in healthcare use in Finland and provides supporting evidence of changes in the socioeconomic gradient in health service use and in important outcomes. The potential adverse effect of healthcare reform on timely access to effective care for people on low incomes provides a plausible explanation that deserves further attention. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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25. Human Health Impact of Exposure to Airborne Particulate Matter in Pearl River Delta, China.
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Peng Xie, Xiaoyun Liu, Zhaorong Liu, Tiantian Li, Liujv Zhong, and Yunrong Xiang
- Subjects
AIRBORNE infection ,CONFIDENCE intervals ,LIFE expectancy - Abstract
To evaluate the potential public health impact of exposure to airborne particulate matter, concentrations of PM and PM were measured at 16 monitoring stations in Pearl River Delta. Epidemiological studies were collected, and meta-analysis method was used to get the exposure-response functions for health effects on mortality of residents in China. Chinese studies reported somewhat lower exposure-response coefficients as compared with studies abroad. Both Poisson model and life-table approach were used to estimate the health effects including acute effects and chronic effects. For short-term exposure, 2,700 (95% confidence interval (CI), 2,200-3,400) premature deaths would be prevented annually if PM daily concentrations reduced to below World Health Organization (WHO) guideline value. Much more benefits would be gained for long-term exposure. The annual avoidable deaths would be 42,000 (95% CI, 28,000-55,000) and 40,000 (95% CI, 23,000-54,000) for PM and PM, respectively, if the particulate matter annual concentrations were reduced to below WHO guideline values. And the average lifespan of residents would prolong 2.57 years for PM and 2.38 years for PM if reducing the PM annual concentrations. The benefits varied greatly in different areas and different manage strategies should be carried out to protect human health effectively. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
26. Epidemiologic aspects of cancer prevention in Germany.
- Author
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Becker, Nikolaus
- Abstract
In Germany, as in other highly industrialized countries, cancer is the second most common cause of death. With approximately 210,000 individuals dying each year from malignant tumours, roughly one in four deaths in Germany can currently be attributed to cancer. Only in the past few years has there been a slow decline in the age-standardized mortality rates for cancer, even among men. This follows a long period of some decades, during which the mortality steadily increased and then persisted at a high level. The reversal, however, does not mean that the situation is no longer a cause for concern. In fact, for the most common cause of death, namely the cardiovascular diseases, a much greater decrease in mortality has been observed for many years now. If this trend continues, cancer could become the largest killer in another 15 to 20 years. On the other hand, we have been aware since the end of the 1960s that the majority of cancers are caused by environmental influences and are thus, in principle, avoidable. In the present contribution we present: (a) the fundamental arguments to support the thesis that a large proportion of cancers, and of cancer deaths, could be avoided; and (b) an estimate for Germany of both the theoretical potential of primary cancer prevention and also the practically attainable potential. The estimates are based on very conservative assumptions. They yield, for the theoretical potential, values in the range 43–65% and for the reduction actually obtainable in the medium term due to primary prevention, values of 18–31%. [ABSTRACT FROM AUTHOR]
- Published
- 2001
- Full Text
- View/download PDF
27. Raummuster der Mortalität in Deutschland und ihre Entwicklungstendenzen zwischen 1998 und 2004
- Author
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Behrendt, Holger
- Published
- 2012
- Full Text
- View/download PDF
28. Human Health Impact of Exposure to Airborne Particulate Matter in Pearl River Delta, China
- Author
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Xie, Peng, Liu, Xiaoyun, Liu, Zhaorong, Li, Tiantian, Zhong, Liujv, and Xiang, Yunrong
- Published
- 2011
- Full Text
- View/download PDF
29. Confidential enquiry into avoidable vehicle accident deaths in the province of Modena, Italy
- Author
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Lauriola, P., Tosatti, F., Schiavi, A., Fiandri, M., Frank, G., Michelacci, M., Zoli, M.A., Castellini, P., Pelosi, S., Verderio, P., Duca, G., and Morosini, P.
- Published
- 2000
- Full Text
- View/download PDF
30. Determinants of avoidable deaths from ischemic heart disease in East and West Germany
- Author
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Ansgar Wübker, Christoph Schwierz, Belgian Health Care Knowledge Centre (KCE), Institutional Economics and Health Systems Management, and Witten/Herdecke University
- Subjects
medicine.medical_specialty ,Pediatrics ,Ischemic heart disease ,Disease ,Modernization theory ,German ,03 medical and health sciences ,0302 clinical medicine ,Germany ,Epidemiology ,Avoidable deaths ,Intracardiac catheters ,medicine ,030212 general & internal medicine ,cardiovascular diseases ,ddc:610 ,Medicine, Social Medicine ,Socioeconomic status ,Social sciences, sociology, anthropology ,Health policy ,ComputingMilieux_MISCELLANEOUS ,Sozialwissenschaften, Soziologie ,Medizin und Gesundheit ,business.industry ,030503 health policy & services ,Public health ,Mortality rate ,Health Policy ,Public Health, Environmental and Occupational Health ,language.human_language ,3. Good health ,Medizin, Sozialmedizin ,Medicine and health ,language ,ddc:300 ,Gesundheitspolitik ,0305 other medical science ,business ,Demography - Abstract
Objective: Within Germany, a significant decrease in avoidable mortality from ischemic heart disease (IHD) has been observed since the early 1990s. The objective of this paper is to identify the specific reasons that have led to the decrease in the number of avoidable deaths from IHD in West and East Germany from 1996 to 2004. Methods: We analyzed the mortality rate from IHD of the male population aged less than 65 years on the regional level of German counties over the 1996–2004 period. Methodologically, after adjusting for a number of health structure variables, the socioeconomic structure of each region, and yearly time trends in avoidable mortality, we accounted for unobservable differences among regions by using a fixed-effect estimator. Results: Our main result reveals that the number of intracardiac catheter facilities, an important diagnostic tool for IHD, significantly accounts for decreases in avoidable mortality from IHD. This is important, as the modernization of the East German health sector included a considerable catching-up process in the number of IC facilities provided relative to West Germany. Conclusion: Our results suggest that the modernization of the East German health sector may have contributed to saving people from premature deaths.
- Published
- 2010
31. Determinants of Avoidable Deaths from Ischaemic Heart Diseases in East and West Germany
- Author
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Schwierz, Christoph and Wübker, Ansgar
- Subjects
Medizintechnisches Gerät ,I12 ,Avoidable deaths ,I19 ,ischaemic heart disease ,Sterblichkeit ,intracardiac catheters ,Neue Bundesländer ,Germany ,ddc:330 ,cardiovascular diseases ,Wirtschaftliche Anpassung ,Deutschland ,Herzkrankheit ,Alte Bundesländer - Abstract
The objective of this paper is to identify selected forces of the decrease in the number of avoidable deaths from ischaemic heart diseases (IHD) inWest and East Germany from 1996 to 2004. Our main result reveals that the number of intracardiac catheter facilities,which are an important diagnostic tool for IHD, do significantly account for decreases in avoidable mortality from IHD.This is important, as the modernization of the East German health sector included a considerable catch-up process in the number of IC facilities provided relative to West Germany.
- Published
- 2009
32. Investigating unavoidable deaths and unequal access to health care.
- Author
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Russ, Lesley, Emerson, Eric, and Marriott, Anna
- Subjects
HEALTH services accessibility ,INTELLECTUAL disabilities ,WORLD Wide Web ,INFORMATION resources ,GOVERNMENT policy ,SOCIETIES - Abstract
In March 2010 the government announced two related initiatives to help address the health inequalities faced by people with learning disabilities in England. First, a confidential inquiry into the deaths of people with learning disabilities. Second, a Learning Disabilities Observatory is to be established to collate, disseminate and improve information on the health of people with learning disabilities. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
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