title: What, if anything, does amenable mortality tell us about regional health system performance?
abstract: OBJECTIVE
  Amenable mortality is proposed as a health system performance measure, and has been used in comparisons across countries and socio-economic strata. We assess its utility as a health region–level indicator in Canada.
  
  
  METHODS
  We classified all deaths in British Columbia from 2002 to 2009 using two common definitions of amenable mortality. Counts and standardized rates were calculated for 16 health regions. To assess reliability, sensitivity and validity, we compared rates across regions and over time, and examined correlations with premature and all-cause mortality.
  
  
  RESULTS
  Of the 238,849 deaths in the study period, 6.6% or 13.7% were classified as amenable (depending on the definition used). Rates were stable or falling in more populated regions, but unstable with large confidence intervals elsewhere. Correlation with overall mortality was strong.
  
  
  CONCLUSIONS
  Though amenable mortality is appealing as a feasible, understandable indicator, we question whether it is appropriate for comparisons at a subprovincial level.
authors: Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. rlavergne@chspr.ubc.ca
authors: M Ruth
authors: MR
authors: Lavergne
authors: Kimberlyn
authors: K
authors: McGrail
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D012041:Regional Medical Programs / Q000592:standards* / Q000706:statistics & numerical data; D055815:Young Adult
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