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R Westerling

Publications and source records attributed to R Westerling.

At least 19 recordsLinked to original sources

The European Community 'avoidable death indicators' in Sweden 1974-1985.

Avoidable mortality in Sweden 1974-1985 was analysed using a European Community (EC) Working Group list of 'avoidable death indicators." The list includes causes of death that in certain age groups were defined as indicators of the outcome of medical care intervention or for some conditions, indicators of the national health policies. About 10 out of 14 medical health care indicators occurred in less than 50 cases per year. Death rates decreased over the 12-year period studied for most avoidable death indicators. For women, however, the death rate for malignant neoplasms of the trachea, bronchus and lung increased significantly. Swedish total mortality for ages 5-64 years was lower than the EC standards 1974-1978 and 1980-1984. Most of the avoidable causes of death had a relatively low standard mortality rate (SMR) when compared to both the EC standard and to the Swedish SMR for total mortality. For asthma, however, the Swedish SMR was higher. The development and implementation of the avoidable death concept and methodology is discussed.

Adolescent

"Avoidable" causes of death in Sweden 1974-85.

Mortality from potentially avoidable causes of death in Sweden 1974-85 for ages 0-64 years was analysed, based on a list published by Rutstein et al., [N Engl J Med 294: 582, 1976] of conditions that were suggested to serve as negative indicators of the quality of health care. In females 22% of deaths and in males 18% of deaths had underlying causes that were included in the list. Deaths from avoidable causes in the Rutstein list were concentrated to a limited number of causes of death and cause of death groups, such as neoplasms and diseases of the respiratory system. Both preventable and treatable conditions were found among the most common avoidable causes of death. There were differences in the causes of death that were most common between different age groups. A large number of the avoidable causes of death were relatively rare in Sweden. Areas for continued methodological development are suggested concerning the choice of avoidable causes of death and the definition of standards.

Adolescent

Trends in "avoidable" mortality in Sweden, 1974-1985.

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.

Adolescent

Diagnoses associated with the prescription of psychotropic drugs at a Swedish health centre.

Data on drug prescribing to residents of the municipality of Tierp in 1978 were linked to data on visits to the Tierp health centre in order to examine which diagnoses were associated with psychotropic drug prescribing. The diagnostic patterns were analyzed with respect to sex, age, and level of drug use of patients. Only one quarter of the patients for whom psychotropic drugs were prescribed in connection with a visit to the health centre were also given a psychiatric diagnosis. Even among those patients who were prescribed five or more psychotropic drugs, only four out of ten had a psychiatric diagnosis. Among those patients who were prescribed an antidepressant, only six out of ten had a psychiatric diagnosis. A relation between psychotropic drug use and certain non-psychiatric diagnoses such as hypertension, diabetes and ischaemic heart disease was observed.

Adolescent

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Economics