ABSTRACT
BACKGROUND: Avoidable mortality (AM) has been proposed as the indicator of the quality and the efficacy of health care services and a parameter useful to distribute health care resources. The aim of this study was to analyze the size and geographic variability of AM in the Community of Valencia, Spain (1975-1990). METHODS: The causes of AM were analyzed by the classification of Holland divided into indicators of medical care (IMC) and indicators on national health care policy (INHCP) in addition to the causes of the Charlton classification. Standard rates for Spain and the European Community, the rate of masculinity and contribution to total mortality were calculated. Geographic distribution by areas and provinces was analyzed by the rate of standardized mortality. RESULTS: According to the Holland classification AM was 30% of the deaths from 5 to 64 years of age. Out of these cases, 18.5% corresponded to INHCP and 11.1% to IMC. According to the Charlton classification, this percentage was 3.6%. A considerable variation was observed among the 20 areas analyzed due to many causes. The geographic distribution by groups (IMC, INHCP and the Charlton classification) is quite homogeneous. The worse results corresponded to the city of Valencia and to the area 21 (area of the city of Alicante). CONCLUSIONS: A great variation was found in the results regarding geographic distribution for individual causes of death while the distribution was quite homogeneous for all of the groups of mortality with the worst results being observed in large urban centers.
