{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T15:05:33Z","timestamp":1774278333945,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Epidemiol Community Health"],"published-print":{"date-parts":[[1992,10]]},"abstract":"<jats:p>STUDY OBJECTIVE--The aim was to analyse trends in \"avoidable\" mortality in Sweden, and to contribute to the methodology of avoidable mortality as an index of the quality of care. SETTING AND PARTICIPANTS--All deaths of Swedish citizens and other residents in Sweden during the period 1974-1985 were analysed as to causes of death between ages 0 and 64 years. MEASUREMENTS AND MAIN RESULTS--Total mortality delined during the 12 year period studied. Avoidable causes of death were grouped into preventable and treatable causes according to Rutstein's classification. In men, treatable diseases declined more during the 12 year period studied than did total mortality. When lung cancer was excluded, preventable diseases declined for both sexes. Certain avoidable causes of death decreased compared to total mortality, while some others showed an increase. The death rate increased for some avoidable causes of death such as pneumonia other than viral. In women death rates increased for chronic bronchitis and emphysema as well as for malignant neoplasms of trachea, bronchus, and lung, while for boys aged 1-14 years bronchitis NOS and asthma showed an increasing death rate. CONCLUSIONS--The study indicates that the avoidable mortality method is sensitive enough to describe important changes in the mortality pattern. The explicit definition of treatable and preventable causes of death constitutes a methodological development in epidemiological analysis of this type. Further studies on the quality of care should combine this method with other methods examining the structure and process of health care.<\/jats:p>","DOI":"10.1136\/jech.46.5.489","type":"journal-article","created":{"date-parts":[[2008,11,12]],"date-time":"2008-11-12T15:10:54Z","timestamp":1226502654000},"page":"489-493","source":"Crossref","is-referenced-by-count":21,"title":["Trends in \"avoidable\" mortality in Sweden, 1974-1985."],"prefix":"10.1136","volume":"46","author":[{"given":"R","family":"Westerling","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1992,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1136\/jech.44.2.106","article-title":"\"Avoidable\" mortality and health services: a review of aggregate data studies","volume":"44","author":"Mackenbach, J.P.; Bouvier-Colle, M.H.; Jougla, E.","year":"1990","unstructured":"Mackenbach JP, Bouvier-Colle MH, Jougla E. \"Avoidable\" mortality and health services: a review of aggregate data studies. J Epidemiol Community Health 1990; 44: 106-11.","journal-title":"J Epidemiol Community Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/S0140-6736(86)90664-1","article-title":"The effect of health services on mortality: decline in death rates from amenable and nonamenable causes in Finland, 1969-1981","volume":"i:","author":"Poikolainen, K.; Eskola, J.","year":"1986","unstructured":"Poikolainen K, Eskola J. The effect of health services on mortality: decline in death rates from amenable and nonamenable causes in Finland, 1969-1981. Lancet 1986; i: 199-202.","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1136\/bmj.292.6516.295","article-title":"Some international comparisons of mortality amenable to medical intervention","volume":"292","author":"Charlton, J.R.H.; Velez, R.","year":"1986","unstructured":"Charlton JRH, Velez R. Some international comparisons of mortality amenable to medical intervention. BMJ 1986; 292: 295-300.","journal-title":"BMJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/0277-9536(88)90278-X","article-title":"Post-1950 mortality trends and medical care: gains in life expectancy due to declines in mortality from conditions amenable to medical intervention in The Netherlands","volume":"27","author":"Mackenbach, J.P.; Looman, C.W.N.; Kunst, A.E.; Habbema, J.D.F.; van der Maas, P.J.","year":"1988","unstructured":"Mackenbach JP, Looman CWN, Kunst AE, Habbema JDF, van der Maas PJ. Post-1950 mortality trends and medical care: gains in life expectancy due to declines in mortality from conditions amenable to medical intervention in The Netherlands. Soc Sci Med 1988; 27: 889-94.","journal-title":"Soc Sci Med"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1056\/NEJM197603112941104","article-title":"Measuring ther quality of medical care","volume":"294","author":"Rutstein, D.D.; Berenberger, W.; Chalmers, T.C.; Fishchmen, P.A.; Perrin, E.B.","year":"1976","unstructured":"Rutstein DD, Berenberger W, Chalmers TC, Fishchmen PA, Perrin EB. Measuring ther quality of medical care. N Engl J Med 1976; 294: 582-8.","journal-title":"N Engl J Med"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1093\/intqhc\/2.3-4.227","article-title":"Avoidable death as a measure of quality","volume":"2","author":"Holland, W.W.","year":"1990","unstructured":"Holland WW. Avoidable death as a measure of quality. Quality Assurance in Health Care 1990; 2: 227-33.","journal-title":"Quality Assurance in Health Care"},{"key":"ref_7","first-page":"691","article-title":"Geographical variation in mortality from conditions amenable to medical interventions in England and Wales","volume":"i:","author":"Charlton, J.R.H.; Hartley, R.M.; Silver, R.; Holland, W.W.","unstructured":"Charlton JRH, Hartley RM, Silver R, Holland WW. Geographical variation in mortality from conditions amenable to medical interventions in England and Wales. Lancet 1983, i: 691-6.","journal-title":"Lancet 1983"},{"key":"ref_8","article-title":"International statistical classification of diseases, injuries, and causes of death, 8th revision","author":"Organization, World Health","year":"1965","unstructured":"World Health Organization. International statistical classification of diseases, injuries, and causes of death, 8th revision. Geneva: WHO, 1965."},{"key":"ref_9","article-title":"(Quality control of causes of death.) Stockholm: Statistika Centralbyran. Ratts-och socialstatistik PM 1983: 5","author":"av dodsorsaksuppgifter, Kvalitetskontroll","unstructured":"Kvalitetskontroll av dodsorsaksuppgifter. (Quality control of causes of death.) Stockholm: Statistika Centralbyran. Ratts-och socialstatistik PM 1983: 5. (In Swedish.)"},{"key":"ref_10","article-title":"SAS user's guide: statistics. Version 5","author":"SAS Institute","year":"1985","unstructured":"SAS Institute. SAS user's guide: statistics. Version 5 Cary, NC: SAS Institure Inc, 1985."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"221","DOI":"10.2190\/N1NJ-LW6J-URLA-D1EL","article-title":"Better health-but not for all: the Swedish public health report","volume":"19","author":"Diderichsen, F.; Lindberg, G.","year":"1987","unstructured":"Diderichsen F, Lindberg G. Better health-but not for all: the Swedish public health report, 1987. Int Health Serv 1989; 19: 221-55.","journal-title":"Int Health Serv"},{"key":"ref_12","first-page":"5","article-title":"Changing trends in coronary heart mortality; possible explanations","volume":"72","author":"Pyorala, K.; Epstein, F.H.; Kornitzer, M.","year":"1985","unstructured":"Pyorala K, Epstein FH, Kornitzer M. Changing trends in coronary heart mortality; possible explanations. Cardiology 1985; 72: 5-10.","journal-title":"Cardiology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1093\/ije\/12.4.405","article-title":"Regional trends in incidence of cervical cancer in Denmark in relation to local smear-taking activity","volume":"12","author":"Lynge, E.","year":"1983","unstructured":"Lynge E. Regional trends in incidence of cervical cancer in Denmark in relation to local smear-taking activity. Int Epidemiol 1983; 12: 405-13.","journal-title":"Int Epidemiol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1136\/bmj.292.6514.191","article-title":"Does treatment of hypertension explain the decline in mortality from stroke?","volume":"292","author":"Bonita, R.; Beaglehole, R.","year":"1986","unstructured":"Bonita R, Beaglehole R. Does treatment of hypertension explain the decline in mortality from stroke? BMJ 1986; 292: 191-2.","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"825","DOI":"10.7326\/0003-4819-101-6-825","article-title":"The decline in ischemic heart disease mortality rates. An analysis of the comparative effects of medical interventions and changes in lifestyle","volume":"101","author":"Goldman, L.; Cook, F.","year":"1984","unstructured":"Goldman L, Cook F. The decline in ischemic heart disease mortality rates. An analysis of the comparative effects of medical interventions and changes in lifestyle. Ann Intern Med 1984; 101: 825-36.","journal-title":"Ann Intern Med"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1136\/bmj.292.6512.33","article-title":"Medical management and the decline in mortality from coronary heart disease","volume":"292","author":"Beaglehole, R.","year":"1986","unstructured":"Beaglehole R. Medical management and the decline in mortality from coronary heart disease. BMJ 1986; 292: 33-5.","journal-title":"BMJ"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.2105\/AJPH.66.12.1180","article-title":"The effect of antibiotics on mortality from infectious diseases in Sweden and Finland","volume":"66","author":"Hemminki, E.; Paakkulainen, A.","year":"1976","unstructured":"Hemminki E, Paakkulainen A. The effect of antibiotics on mortality from infectious diseases in Sweden and Finland. Am J Public Health 1976; 66: 1180-4.","journal-title":"Am J Public Health"},{"key":"ref_18","article-title":"The role of medicine, dream, mirage or nemesis?","author":"McKeown, T.","year":"1976","unstructured":"McKeown T. The role of medicine, dream, mirage or nemesis? London: Nuffield Provincial Hospital Trust, 1976."},{"key":"ref_19","article-title":"Does medical care do any good?","volume-title":"Handbook of health, health care and the health professions","author":"Levine, S.; Feldman, J.J.; Elison, J.","year":"1983","unstructured":"Levine S, Feldman JJ, Elison J. Does medical care do any good? In: Mechanic D, ed. Handbook of health, health care and the health professions. New York: The Free Press, 1983."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0097-5990(16)30021-5","article-title":"Criteria and standards for quality assessment and monitoring","volume":"12","author":"Donabedian, A.","year":"1986","unstructured":"Donabedian A. Criteria and standards for quality assessment and monitoring. Quality Review Bull 1986; 12: 99-108.","journal-title":"Quality Review Bull"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1136\/jech.42.4.325","article-title":"Regional differences in mortality from conditions amenable to medical intervention in The Netherlands: a comparison of four time periods","volume":"42","author":"Mackenbach, J.P.; Kunst, A.E.; Looman, C.W.N.; Habbema, J.D.F.; van der Maas, P.J.","year":"1988","unstructured":"Mackenbach JP, Kunst AE, Looman CWN, Habbema JDF, van der Maas PJ. Regional differences in mortality from conditions amenable to medical intervention in The Netherlands: a comparison of four time periods. J Epidemiol Community Health 1988; 42: 325-32.","journal-title":"J Epidemiol Community Health"},{"key":"ref_22","first-page":"3","article-title":"The definition of quality: a conceptual exploration. In: Explorations in quality assessment and monitoring. Volume I. The definition of quality and approaches to its assessment","author":"Donabedian, A.","year":"1980","unstructured":"Donabedian A. The definition of quality: a conceptual exploration. In: Explorations in quality assessment and monitoring. Volume I. The definition of quality and approaches to its assessment. Ann Arbor, MI: Health Adminsitration Press, 1980: 3-31."},{"key":"ref_23","first-page":"769","article-title":"Basic approaches to assessment: structure, process, and outcome. In: Explorations in quality assessment and monitoring. Volume I. The definition of quality and approaches to its assessment","author":"Donabedian, A.","year":"1980","unstructured":"Donabedian A. Basic approaches to assessment: structure, process, and outcome. In: Explorations in quality assessment and monitoring. Volume I. The definition of quality and approaches to its assessment. Ann Arbor, MI: Health Administration Press, 1980: 769-128."},{"key":"ref_24","article-title":"Avoidable causes of death in Sweden 1974-85. Quality Assurance in Health Care","author":"Westerling, R.","year":"1992","unstructured":"Westerling R. Avoidable causes of death in Sweden 1974-85. Quality Assurance in Health Care. 1992 (in press)."},{"key":"ref_25","article-title":"Community atlas of \"avoidable death\". (Commission of the European Communities health services research series No 3.)","author":"WWEuropean, Holland","year":"1988","unstructured":"Holland WW, ed. European Community atlas of \"avoidable death\". (Commission of the European Communities health services research series No 3.) Oxford: Oxford Medical Publications, 1988."},{"key":"ref_26","article-title":"Community atlas of \"Avoidable death\"","volume-title":"Commission of the European Communities health services research series No 6","volume":"vol","author":"WWEuropean, Holland; 1","year":"1991","unstructured":"Holland WW, ed. European Community atlas of \"Avoidable death\" 2nd ed, vol 1. (Commission of the European Communities health services research series No 6.) (Oxford: Oxford Medical Publications, 1991.","edition":"2nd ed"},{"key":"ref_27","article-title":"Proefschrift","author":"Mortality, Mackenbach J.P.; medical care","year":"1988","unstructured":"Mackenbach JP. Mortality and medical care. Proefschrift. Rotterdam: Erasmus Universitet, 1988."},{"key":"ref_28","first-page":"1","article-title":"Assessing the quality of medical care using outcome measures: an overview of the method","volume":"15","author":"Brook, R.H.; Davies-Alery, A.; Greenfield, S.","year":"1977","unstructured":"Brook RH, Davies-Alery A, Greenfield S. Assessing the quality of medical care using outcome measures: an overview of the method. Med Care 1977; 15 (suppl): 1-84.","journal-title":"Med Care"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech.46.5.489","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T11:37:58Z","timestamp":1759837078000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech.46.5.489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,10]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[1992,10,1]]},"published-print":{"date-parts":[[1992,10]]}},"alternative-id":["10.1136\/jech.46.5.489"],"URL":"https:\/\/doi.org\/10.1136\/jech.46.5.489","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,10]]}}}