title: Declining Amenable Mortality: Time Trend (2000-2013) and Geographic Area Analysis.
abstract: To update amenable mortality in 32 OECD countries at 2013 (or last available year), to describe the time trends during 2000-2013, and to evaluate the association of these trends with various geographic areas.
  
  
  
  Secondary data from 32 countries during 2000-2013, gathered from the World Health Organization Mortality Database.
  
  
  
  Time trend analysis.
  
  
  
  Using Nolte and McKee's list, age-standardized amenable mortality rates (SDRs) were calculated as the annual number of deaths over the population aged 0-74 years per 100,000 inhabitants. We performed a mixed-effects polynomial regression analysis on the annual SDRs to determine whether specific geographic areas were associated with different SDR trajectories over time.
  
  
  
  The OECD average annual decrease was 3.6/100,000 (p < .001), but slowed over time (coefficient for the quadratic term = 0.11, p < .001). Eastern and Atlantic European countries had the steepest decline (-6.1 and -4.7, respectively), while Latin American countries had the lowest slope (-1.7). The OECD average annual decline during the 14-year period was -0.5 (p < .001) for cancers and -2.5 (p < .001) for cardiovascular diseases, with significant differences among countries.
  
  
  
  Declining trend of amenable SDRs was continuing to 2013 but with steepness change compared with previous periods and with a slowdown.
authors.affiliation: Department of Public Health Sciences and Pediatrics, Università di Torino, Torino, Italy.
authors.forename: Maria Michela
authors.initials: MM
authors.lastname: Gianino
authors.affiliation: Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - Università di Bologna, Bologna, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Lenzi
authors.affiliation: Department of Public Health Sciences and Pediatrics, Università di Torino, Torino, Italy.
authors.forename: Aida
authors.initials: A
authors.lastname: Muça
authors.affiliation: Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - Università di Bologna, Bologna, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Fantini
authors.affiliation: Department of Public Health Sciences and Pediatrics, Università di Bologna, Torino, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Siliquini
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Damiani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D019049:Developed Countries / Q000706:statistics & numerical data*; D005260:Female; D014943:Global Health; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D011787:Quality of Health Care; D055815:Young Adult
keywords: Amenable mortality; OECD countries; geographic area; health care services performance