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An efficient health care system is a priority for all developed countries, and it is an important prerequisite for economic prosperity. Efficiency is measured by the ratio of inputs to outputs of a given system. In the case of health care, inputs include health care expenditure and human and material resources. There are several outputs that can be used to assess efficiency. Among the most important and frequently used are avoidable mortality rates. The consequences of avoidable mortality are understandably very unpleasant for those involved. From a national perspective, avoidable mortality also has serious macroeconomic consequences. The aim of this paper is to assess the efficiency of the health care systems of the member states of the European Union using avoidable mortality rates. Data were taken from the latest available online datasets on avoidable mortality published by Eurostat in 2019. Correlation analysis and multivariate statistical analysis were used. [ABSTRACT FROM AUTHOR]

Background: Disparities in avoidable mortality have never been evaluated in Italy at the national level. The present study aimed to assess the association between socioeconomic status and avoidable mortality. Methods: The nationwide closed cohort of the 2011 Census of Population and Housing was followed up for 2012–2019 mortality. Outcomes of preventable and of treatable mortality were separately evaluated among people aged 30–74. Education level (elementary school or less, middle school, high school diploma, university degree or more) and residence macro area (North-West, North-East, Center, South-Islands) were the exposures, for which adjusted mortality rate ratios (MRRs) were calculated through multivariate quasi-Poisson regression models, adjusted for age at death. Relative index of inequalities was estimated for preventable, treatable, and non-avoidable mortality and for some specific causes. Results: The cohort consisted of 35,708,459 residents (48.8% men, 17.5% aged 65–74), 34% with a high school diploma, 33.5% living in the South-Islands; 1,127,760 deaths were observed, of which 65.2% for avoidable causes (40.4% preventable and 24.9% treatable). Inverse trends between education level and mortality were observed for all causes; comparing the least with the most educated groups, a strong association was observed for preventable (males MRR = 2.39; females MRR = 1.65) and for treatable causes of death (males MRR = 1.93; females MRR = 1.45). The greatest inequalities were observed for HIV/AIDS and alcohol-related diseases (both sexes), drug-related diseases and tuberculosis (males), and diabetes mellitus, cardiovascular diseases, and renal failure (females). Excess risk of preventable and of treatable mortality were observed for the South-Islands. Conclusions: Socioeconomic inequalities in mortality persist in Italy, with an extremely varied response to policies at the regional level, representing a possible missed gain in health and suggesting a reassessment of priorities and definition of health targets. [ABSTRACT FROM AUTHOR]

Introduction: This study provides an economic assessment of the health effects due to exposure to particulate matter PM2.5 in three medium-size cities of northwestern Mexico: Los Mochis, Culiacan and Mazatlán. People in these cities are exposed to high pollutant concentrations that exceed limits suggested in domestic and international guidelines. PM2.5 is an air contaminant negatively associated with people's health when is highly concentrated in the atmosphere; its diameter is below 2.5 µm and causes the air to appear hazy when levels are elevated. To account for the economic impact of air pollution, a Health Impact Assessment (HIA) was used by the means of the European Aphekom Project. We figured the cost-savings of complying with current environmental standards and computed gains in life expectancy, total avoidable premature mortality, preventable cardiovascular disease, and the economic costs of air pollution related to PM2.5. A formal analysis of air pollution epidemiology is not pursued in this paper. Results: The cost of reducing PM2.5 pollution associated with negative health outcomes was based on two different scenarios: Official Mexican Standard (NOM, Spanish acronym) and World Health Organization (WHO) environmental standards. The mean PM2.5 concentrations in 2017 were 22.8, 22.4 and 14.1 µg/m3 for Los Mochis, Mazatlán and Culiacan, respectively. Conclusions: The mean avoidable mortality for all causes associated to PM2.5 exposure in these cities was 638 for the NOM scenario (i.e., with a reduction to 12 µg/m3) compared to 739 for the WHO scenario (reduction to 10 µg/m3). Complying with the WHO guideline of 10 µg/m3 in annual PM2.5 mean would add up to 15 months of life expectancy at age 30, depending on the city. The mean economic cost per year of the PM2.5 effects on human life in these three cities was USD 600 million (NOM scenario) and USD 695 million (WHO scenario). Thus, effective public health and industrial policy interventions to improve air quality are socially advantageous and cost-saving to promote better health. [ABSTRACT FROM AUTHOR]

Objective: To compare avoidable mortality for causes amenable to medical care and suicide in physicians versus other professionals with similar university studies and socioeconomic position in Spain. Methods: All people aged 25–64 years who were employed on 1 November 2001 (8,697,387 men and 5,282,611 women) were included. Their vital status was followed for 10 years and the cause of death of deceased was recorded. Using a Poisson regression to estimate the mortality rate ratio (MRR), we compared mortality due to causes of death amenable to medical care, all other causes, and suicide in physicians versus other professionals. Mortality in physicians was used as a reference. Results: The lowest MRR for causes amenable to medical care was observed in engineers/architects (men: 0.84, 95% confidence interval [CI] 0.72, 0.97; women: 0.93, 95% CI 0.64, 1.35) and healthcare professions other than physicians/pharmacists/nurses (men: 0.86, 95% CI 0.56, 1.34; women: 0.69, 95% CI 0.32, 1.46). Regarding mortality for all other causes of death, professionals from these and other occupations presented lower mortality than physicians. Other healthcare professions, entrepreneurs, and managers/executives completed suicide at a higher rate than physicians. Conclusion: Although the accessibility to the healthcare system and to the pharmacological drugs could suggest that physicians would present low rates for causes amenable to medical care and high rates of suicide, our results show that this is not the case in Spain. [ABSTRACT FROM AUTHOR]