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Costos económicos de la mortalidad evitable en Cartagena, Colombia, 2000-2005 Translated title: The economic cost of avoidable mortality in Cartagena, Colombia, 2000-2005

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      Abstract

      Objetivo Valorar los costos económicos de la pérdida de capital humano producto de las Muertes evitables en Cartagena durante el período 2000-2005 a partir de la estimación de los años perdidos de vida potencial totales y la fracción de años perdidos de vida potencial productiva. Métodos Estudio ecológico mixto con serie de tiempo correspondiente al período 2000-2005. Los datos de mortalidad provienen de los registros publicados oficialmente para Colombia por el Departamento Administrativo Nacional de Estadísticas-DANE. Se tomaron como casos de muertes evitables aquellos clasificados según Taucher. Se utilizó el indicador Años Potenciales de Vida Perdidos -APVP- y el indicador Años Potenciales de Vida Productiva Perdidos -APVPP. Las defunciones se ajustaron teniendo en cuenta el subregistro adoptando la metodología Bennett-Horiuchi recomendada por la OMS. Se asumieron dos escenarios: Escenario Mínimo o Piso y Escenario Superior o Techo. Una vez establecido el total de años perdidos por cada período anual se multiplicó por el ingreso mínimo según el Escenario. La base de datos fue analizada utilizando el software Epidat 3.0. Resultados Se presentaron 20 723 defunciones evitables (ajustadas por subregistro). Una de cada tres muertes evitables, según Taucher, ocurridas en Cartagena se hubiese evitado gracias a un diagnóstico y un tratamiento médico precoz. Las muertes violentas son el tipo de muerte evitable que mayores costos generan según el modelo IPC adoptado en el presente estudio. Conclusiones La reducción de las defunciones evitables por diagnóstico y tratamiento médico precoz provocaría una significativa disminución de la mortalidad evitable.

      Translated abstract

      Objective Evaluating the economic cost of loss of human capital produced by preventable deaths in Cartagena, 2000-2005, from estimating years of potential life lost (YPLL) and the percentage of years of potential productive life lost (YPPLL). Methods This was a mixed ecological study, using 2000-2005 time series. Mortality data was taken from the Colombian National Administrative Department of Statistics (DANE) records. Cases of preventable death were classified according to Taucher’s guidelines. YPLL and YPPLL were used as indicators. Deaths were adjusted by adopting WHO-recommended Bennett-Horiuchi methodology for accounting for underreporting. Two scenarios were assumed: a minimum or flat scenario and an upper or roof scenario. Once YPLL for each annual period had been established, they were multiplied by minimum income according to scenario. Epidat 3.0 software was used for analysing the database. Results There were 20,723 preventable deaths (adjusted for underreporting). One out of every three preventable deaths which occurred in Cartagena could have been averted by early diagnosis and medical treatment, according to Taucher. Violent deaths are the kind of avoidable deaths which produce higher costs according to the informationprocessing (IPC) model adopted in this study. Conclusions Reducing preventable deaths by early diagnosis and medical treatment would cause a significant reduction in avoidable mortality.

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      Most cited references 33

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      Geographical variation in mortality from conditions amenable to medical intervention in England and Wales.

      There is a need for indicators of the outcome of health-care services against which the use of resources can be evaluated. From a previously published series of outcome indicators, which included diseases for which mortality is largely avoidable given appropriate medical intervention, causes were selected which were regarded as most amenable to medical intervention (excluding conditions whose control depends mainly on prevention) and for which there were sufficient numbers of deaths to allow an analysis of the variation in mortality rates among the 98 area health authorities of England and Wales. Considerable variation between AHAs was found in mortality from most of these diseases, and this variation remained even after adjustment for social factors. This substantial variation should be examined further in relation to health-service inputs and other factors. A finding of large variations in the quality of health-care delivery in different parts of the country would have important implications for resource allocation.
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        Avoidable mortality by neighbourhood income in Canada: 25 years after the establishment of universal health insurance.

        To examine neighbourhood income differences in deaths amenable to medical care and public health over a 25-year period after the establishment of universal insurance for doctors and hospital services in Canada. Data for census metropolitan areas were obtained from the Canadian Mortality Database and population censuses for the years 1971, 1986, 1991 and 1996. Deaths amenable to medical care, amenable to public health, from ischaemic heart disease and from other causes were considered. Data on deaths were grouped into neighbourhood income quintiles on the basis of the census tract percentage of population below Canada's low-income cut-offs. From 1971 to 1996, differences between the richest and poorest quintiles in age-standardised expected years of life lost amenable to medical care decreased 60% (p<0.001) in men and 78% (p<0.001) in women, those amenable to public health increased 0.7% (p = 0.94) in men and 20% (p = 0.55) in women, those lost from ischaemic heart disease decreased 58% in men and 38% in women, and from other causes decreased 15% in men and 9% in women. Changes in the age-standardised expected years of life lost difference for deaths amenable to medical care were significantly larger than those for deaths amenable to public health or other causes for both men and women (p<0.001). Reductions in rates of deaths amenable to medical care made the largest contribution to narrowing socioeconomic mortality disparities. Continuing disparities in mortality from causes amenable to public health suggest that public health initiatives have a potentially important, but yet un-realized, role in further reducing mortality disparities in Canada.
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          The burden of disease and injury in Australia

          An overview of the results of the Australian Burden of Disease (ABD) study is presented. The ABD study was the first to use methodology developed for the Global Burden of Disease study to measure the burden of disease and injury in a developed country. In 1996, mental disorders were the main causes of disability burden, responsible for nearly 30% of total years of life lost to disability (YLD), with depression accounting for 8% of the total YLD. Ischaemic heart disease and stroke were the main contributors to the disease burden disability-adjusted life years (DALYs), together causing nearly 18% of the total disease burden. Risk factors such as smoking, alcohol consumption, physical inactivity, hypertension, high blood cholesterol, obesity and inadequate fruit and vegetable consumption were responsible for much of the overall disease burden in Australia. The lessons learnt from the ABD study are discussed, together with methodological issues that require further attention.
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            Author and article information

            Affiliations
            [1 ] Universidad de Cartagena Colombia
            [2 ] Universidad de Cartagena Colombia
            Contributors
            Role: ND
            Role: ND
            Journal
            rsap
            Revista de Salud Pública
            Rev. salud pública
            Instituto de Salud Publica, Faculdad de Medicina -Universidad Nacional de Colombia (Bogotá )
            0124-0064
            December 2009
            : 11
            : 6
            : 970-978
            S0124-00642009000600013

            http://creativecommons.org/licenses/by/4.0/

            Product
            Product Information: SciELO Colombia
            Categories
            Health Policy & Services

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