Healthcare Performance Evaluation using preventable mortality criteria

Abstract

Introduction. There is an urgent need to develop independent objective criteria for evaluating the Moscow healthcare system in accordance with the priorities of increasing life expectancy. Objectives. The study is aimed at assessing the methodology of preventable mortality by Moscow healthcare specialists, identifying the scale and dynamics of preventable mortality in Moscow on the basis of this methodology and assessing the impact of healthcare on life expectancy of Moscow population according to the set of criteria. Methods and materials. In 2019, an electronic survey was conducted among the experts from 14 medical specialties (937 respondents) working in inpatient and/or outpatient organizations. Upon the received results, trends and causes of preventable mortality in Moscow are presented. Results. There are three criteria that indicate the effectiveness of Moscow healthcare system over the past two decades (2000-2018): rapid-decreasing mortality from preventable causes against the background of the dynamics of total mortality in patients up to 75 years; higher rates of mortality reduction from causes dependent on behavioral risk factors; reduction in preventable mortality share in the life expectancy loss. At the same time, the rates of preventable mortality in Moscow remain quite significant, indicating that there is more potential for reducing premature mortality in Moscow. Of the 6.8 years for males and 3.7 years for females reduced by the maximum possible life expectancy before the age of 75 due to premature mortality, preventable deaths account for 5.0 and 2.3 years, respectively. By reducing mortality from preventable causes classified in group 1 and depending on the quality of medical care, life expectancy at the age of 75 years can be increased according to 2018 data by 2.3 years for men and 1.4 years for women. Due to causes classified in group 2 and dependent on effective primary prevention and public health efforts, the increase could be 2.8 and 0.8 years, respectively. The results of our study reveal potential for reducing mortality from nosological and age perspectives, and can be used to update health policy measures.