Appendix-Demographic Mortality Measures as Indicators of Amenable or Avoidable Deaths in the 50 States of the United States of America. An Example of a Population-Based Health Care Quality Indicator - Applied to Chronic Obstructive Pulmonary Disease (COPD)
Description
In this work, a novel approach to measuring amenable deaths is introduced. The lowest age-specific mortality rates in the USA have been isolated to create normative life tables. The concept of normative life tables was first described in the context of the Global Burden of Disease Study at the University of Washington in Seattle, for measuring the general burden of disease in specific populations. Normative life tables provide an ideal life table for the USA, and shed light on shortcomings in states with comparatively high mortality rates. The normative life table approach is applied for a chronic and frequent health condition in the USA, namely COPD (Chronic Obstructive Lung Disease). The lowest COPD mortality rates in the USA for 2016 have been isolated to create normative COPD life tables. These normative life tables show the best practice for COPD in the USA. Excess deaths in COPD across the states are regarded as amenable deaths, i.e., deaths that with timely and effective medical interventions and public health efforts could have been prevented. California has the lowest proportion of amenable deaths due to COPD. Texas has moderate mortality rates for COPD, while Kentucky has the highest COPD mortalities in the USA, and therefore the highest proportion of amenable deaths in COPD. These changes are also reflected in the life expectancy of individuals with COPD. California has the highest life expectancy for individuals with COPD. In 2016, 50- year-olds with COPD in California were expected to live for an additional 21.01 years, while in Texas they had an additional 17.82 years to live and in Kentucky, only 11.94 years.
The normative life table approach adds to current efforts by providing a fair way of measuring health care performance. It acts as an indicator of health care quality by measuring the share of amenable deaths that, with timely and effective medical interventions and public health efforts, could have been avoided.
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