Measuring avoidable deaths and diseases in New York State.
The measurement of sentinel health events--avoidable deaths and diseases--is a practical and valuable method for assessing the state of the community's health and the performance of the health system in meeting the needs of the population. A comprehensive framework for identification of sentinel health events has been defined by the Working Group on Preventable and Manageable Diseases. The Working Group developed lists that include more than 120 medical conditions for which death or disease is deemed to be potentially avoidable through primary prevention activities or timely and appropriate treatment. Hospital discharge abstract data offer a unique perspective for examining these potentially avoidable negative health outcomes. Such data, available in New York State through the Statewide Planning and Research Cooperative System (SPARCS), are a source of detailed and accessible information on a wide range of morbidity-producing conditions and associated deaths. Among the findings of this sentinel health events study, based on an analysis of SPARCS data, are the following: Among hospitalized residents of New York State in 1983, more than 19,000 deaths occurred that were potentially avoidable. More than one-third of these deaths occurred among persons under age 65. More than 336,000 instances of disease were found that were potentially preventable, amounting to 123 disease occurrences per 1,000 discharges. In the category of sentinel events where each event may be avoidable, only three conditions alone were associated with 75 percent of the deaths and 60 percent of the disease occurrences--malignant neoplasm of the trachea, bronchus, and lung; emphysema or chronic obstructive lung disease(s); and malignant neoplasm of the bladder. In the category of events where some proportion of events may be avoidable, one diagnosis--vascular complications associated with hypertensive disease(s)--was linked with 45 percent of the deaths. Significantly higher rates and ratios for many sentinel events were found among blacks, Medicaid recipients, and users of public hospitals than were found for comparison groups. For example, among patients hospitalized for colon and related neoplasms, black patients were more than twice as likely to die than white patients.(ABSTRACT TRUNCATED AT 400 WORDS)
D001741:Black or African American / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D006302:Health Services Research / Q000379:methods; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D008484:Medicaid / Q000706:statistics & numerical data; D009017:Morbidity; D009518:New York / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States; D044465:White People / Q000706:statistics & numerical data