Incidence of conditions considered amenable to health care in Scotland

Yates, M., Dundas, R., Pell, J.P. & Leyland, A.H. (2017) UK Administrative Data Research Network Annual Research Conference, Royal College of Surgeons, Edinburgh, UK, 1 - 2 June 2017

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Mortality amenable to healthcare intervention are premature deaths (typically before the age of 75) which, theoretically, should not occur in the presence of timely and effective health care. Conditions which are considered amenable to health care include measles, breast and colorectal cancers, hypertensive disease, and asthma.

Rates of amenable mortality have previously been used to measure changes in health care systems' performance over time, or between countries. We aim to use this as an indicator of equity of health care in Scotland. A common criticism of using this indicator is the lack of consideration of disease incidence within the population; as variations in the mortality rates could be reflecting variations in rates of disease incidence, rather than variations in the equity of the health care system. By accounting for disease incidence in the population, more accurate measures of health care performance over time can be estimated. This research will highlight areas of the health system that could be improved, leading to improvements in population health.

Incident occurences of amenable conditions were identified using linked hospital discharge (Scottish Birth, SMR01, SMR06 and SMR11) and death records of all amenable conditions within Scotland from 1996-2013. This enabled rates to be calculated for single and groups of conditions, as well as at different levels of deprivation.

Preliminary results show that whilst there is little difference in the absolute declines between incidence and mortality rates for each sex, relative declines in mortality rates are far higher than those in incidence (men: 41% vs 2.5%, women: 35% vs 1.5%). This suggests that declines in national rates of mortality amenable to health care intervention in Scotland are not driven by declines in hospitalisations; next steps will investigate whether such patterns differ between broad causes of death and deprivation groups.

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