title: [Contribution of amenable mortality to the decrease of overall mortality in Piedmont Region (Northern Italy), 1980-2011].
abstract: OBJECTIVE
  to describe overall and amenable mortality trends over the last 30 years in the Local Health Authorities (LHAs) of Piedmont Region (Northern Italy). By comparing these trends, it is possible to analyse intraregional variability in the performance of the healthcare system.
  
  
  METHODS
  descriptive study.
  
  
  METHODS
  mortality data from the Italian National Institute of Statistics (Istat) for the population between 0 and 74 years resident in Piedmont Region for the period 1980-2011.
  
  
  METHODS
  overall and amenable age-standardised death rates, by gender and health unit; ratio of the differences in amenable and in all-cause mortality (standardised rate difference - SRD: SRDamenable/SRDall-cause) over the observation period.
  
  
  RESULTS
  between 1980 and 2011, overall mortality in Piedmont has decreased from 425.8 x100,000 to 205.5 x100.000 among women, and from 891.6 x100,000 to 390.7 x100,000 among men. The rate of amenable mortality on overall mortality decreased from 40% to 32% among women, and from 33% to 21% among men. Furthermore, amenable mortality contributed to 48% of the overall mortality reduction among women and to 35% among men. Regional results show heterogeneity between health units. This heterogeneity decreased over the three decades and was higher in men than in women.
  
  
  CONCLUSIONS
  although Piedmont is one of the Italian Regions with the highest amenable mortality rate, a considerable decrease of its contribution to the overall mortality was seen in the last three decades. This improvement was not equally among LHAs, and substantial intraregional differences are still present, probably due to different timing and way of introduction of healthcare innovations for prevention and care for amenable to healthcare diseases. The proportion of amenable mortality on overall mortality is much higher among women than men, and it probably depends on the diseases considered in the definition itself.
authors.affiliation: Scuola di specializzazione in igiene e medicina preventiva, Università degli Studi di Padova. teresa.dallazuanna@studenti.unipd.it.
authors.forename: Teresa
authors.initials: T
authors.lastname: Dalla Zuanna
authors.affiliation: Servizio sovrazonale di epidemiologia, Azienda sanitaria locale Torino 3, Regione Piemonte.
authors.forename: Marco
authors.initials: M
authors.lastname: Dalmasso
authors.affiliation: Scuola di specializzazione in igiene e medicina preventiva, Università degli Studi di Torino.
authors.forename: Alberto
authors.initials: A
authors.lastname: Amidei
authors.affiliation: Servizio sovrazonale di epidemiologia, Azienda sanitaria locale Torino 3, Regione Piemonte.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gnavi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D061213:Mortality, Premature / Q000639:trends; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution