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Title: Sentinel amenable mortality: a new way to assess the quality of healthcare by examining causes of premature death for which highly efficacious medical interventions are available
Author: Vergara-Duarte, Montse
Borrell i Thió, Carme
Pérez, Gloria
Martín Sánchez, Juan Carlos
Clèries Soler, Ramon
Buxó, Maria
Martínez-Solanas, Èrica
Yasui, Yutaka
Muntaner, Carles
Benach, Joan
Keywords: Avaluació de l'assistència mèdica
Control de qualitat de l'assistència mèdica
Medical care evaluation
Quality control of medical care
Issue Date: 2-Sep-2018
Publisher: Hindawi
Abstract: Background: amenable mortality, or premature deaths that could be prevented with medical care, is a proven indicator for assessing healthcare quality when adapted to a country or region's specific healthcare context. This concept is currently used to evaluate the performance of national and international healthcare systems. However, the levels of efficacy and effectiveness determined using this indicator can vary greatly depending on the causes of death that are included. We introduce a new approach by identifying a subgroup of causes for which there are available treatments with a high level of efficacy. These causes should be considered sentinel events to help identify limitations in the effectiveness and quality of health provision. Methods: we conducted an extensive literature review using a list of amenable causes of death compiled by Spanish researchers. We complemented this approach by assessing the time trends of amenable mortality in two high-income countries that have a similar quality of healthcare but very different systems of provision, namely, Spain and the United States. This enabled us to identify different levels of efficacy of medical interventions (high, medium, and low). We consulted a group of medical experts and combined this information to help make the final classification of sentinel amenable causes of death. Results: sentinel amenable mortality includes causes such as surgical conditions, thyroid diseases, and asthma. The remaining amenable causes of death either have a higher complexity in terms of the disease or need more effective medical interventions or preventative measures to guarantee early detection and adherence to treatment. These included cardiovascular diseases, diabetes, hypertension, all amenable cancers, and some infectious diseases such as pneumonia, influenza, and tuberculosis. Conclusions: sentinel amenable mortality could act as a good sentinel indicator to identify major deficiencies in healthcare quality and provision and detect inequalities across populations.
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It is part of: BioMed Research International, 2018
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ISSN: 2314-6133
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Ciències Clíniques)

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