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Health care is widely considered to be an important determinant of health. The health care systems of Western Europe have recently experienced significant reforms, under pressure from economic globalization. Similarly, in Eastern Europe, health care reforms have been undertaken in response to the demands of the new market economy. Both of these changes may influence equality in health outcomes. This article aims to identify the mechanisms through which health care may affect inequalities. The authors conducted a literature review of the effects on health inequalities of European health care reforms. Particular reference was paid to interventions in the fields of financing and pooling, allocation, purchasing, and provision of services. The majority of studies were from Western Europe, and the outcomes most often examined were access to services or income distribution. Overall, the quality of research was poor, confirming the need to develop an appropriate impact assessment methodology. Few studies were related to pooling, allocation, or purchasing. For financing and purchasing, the studies showed that publicly funded universal health care reduces the impact of ill health on income distribution, while insurance systems can increase inequalities in access to care. Out-of-pocket payments increase inequalities in access to care and contribute to impoverishment. Decentralizing health services can lead to geographic inequalities in health care access. Nationalized, publicly funded health care systems are most effective at reducing inequalities in access and reducing the effects on health of income distribution. [ABSTRACT FROM AUTHOR]

The Internet of things has produced several heterogeneous devices and data models for sensors/actuators, physical and virtual. Corresponding data must be aggregated and their models have to be put in relationships with the general knowledge to make them immediately usable by visual analytics tools, APIs, and other devices. In this paper, models and tools for data ingestion and regularization are presented to simplify and enable the automated visual representation of corresponding data. The addressed problems are related to the (i) regularization of the high heterogeneity of data that are available in the IoT devices (physical or virtual) and KPIs (key performance indicators), thus allowing such data in elements of hypercubes to be reported, and (ii) the possibility of providing final users with an index on views and data structures that can be directly exploited by graphical widgets of visual analytics tools, according to different operators. The solution analyzes the loaded data to extract and generate the IoT device model, as well as to create the instances of the device and generate eventual time series. The whole process allows data for visual analytics and dashboarding to be prepared in a few clicks. The proposed IoT device model is compliant with FIWARE NGSI and is supported by a formal definition of data characterization in terms of value type, value unit, and data type. The resulting data model has been enforced into the Snap4City dashboard wizard and tool, which is a GDPR-compliant multitenant architecture. The solution has been developed and validated by considering six different pilots in Europe for collecting big data to monitor and reason people flows and tourism with the aim of improving quality of service; it has been developed in the context of the HERIT-DATA Interreg project and on top of Snap4City infrastructure and tools. The model turned out to be capable of meeting all the requirements of HERIT-DATA, while some of the visual representation tools still need to be updated and furtherly developed to add a few features.

Objective: To analyse trends of avoidable mortality in Europe, emphasising causes of death amenable to primary prevention through reduction of exposures, secondary prevention through early detection and treatment, and tertiary prevention through improved treatment and medical care., Design: Descriptive study of mortality from avoidable causes for the years 1955 through 1994, for ages 5-64 at time of death. Using the World Health Organisation Mortality Database, five year death rates were standardised to the world population., Setting: 21 countries of Europe in four regions (northern, central, and southern Europe, Nordic countries)., Participants: All causes of deaths for men and women, aged 5-64, at time of death., Main Results: Between 1955-59 and 1990-94, the reduction in mortality was somewhat greater for avoidable causes than for all causes: 45.8% v 45.1% (women) and 39.3% v 32.6% among men. Reductions in mortality were greater for causes amenable to improved medical care: 77.9% among women and 76.3% among men. The smallest reduction in mortality was seen in women for causes amenable to secondary prevention (11.0%), and in men for causes amendable to primary prevention including tobacco related conditions (16.6%). From a geographical point of view, there were slight differences in trends between European regions, but overall the patterns were similar., Conclusions: The greatest reduction of avoidable mortality in Europe from 1955-94 came from causes amenable to improved treatment and medical care for both sexes. Further reductions of avoidable mortality can be achieved through implementation of primary and secondary prevention activities, such as tobacco control, reduction of occupational exposures, and universal access to breast and cervical cancer screening programmes.

"The aim of this paper is to study [sex,] age and cause differential mortality in the 95 Italian provinces during the last twenty years...." Tabular data on causes of death are presented and compared for regions in Italy and between Italy and the international community. (SUMMARY IN FRE AND ITA), (excerpt)