- 作者：Sté ; phane Verguet ; verguet@uw.edu ; Dean T. Jamison
- 关键词：Country performance in health ; Health system performance ; Rate of decline of mortality ; Level of mortality ; Adult health ; High-income countries
- 刊名：Health Policy
- 出版年：2013
- 出版时间：February, 2013
- 年：2013
- 卷：109
- 期：2
- 页码：137-142
- 全文大小：246 K
Objective
To demonstrate the utility of rates of change in measuring country performance in health using the rate of decline of adult mortality for 22 countries in the OECD as an illustration.Methods
We used adult mortality (the probability of dying between ages 15 and 60) for 1970-2010 by country as our outcome measure. We assessed and ranked country performance in rates of decline of adult mortality for four decades, and compared this to performance in levels of adult mortality.
Principal findings
We identified best and worst performers, and identified changes in performance. For example, for female adult mortality (FAM): in the 1970s, the top performer in the rate of decline was Japan and the worst performer was Denmark; in the 2000s, the top performer was Portugal and the worst performer was the United States. The Netherlands saw the largest improvement in the rate of decline of FAM, from 1991-00 to 2001-10. Finland showed the greatest decrease, from 1971-80 to 1981-90. We found little correlation between performance in rates of decline and performance in levels of FAM.
Conclusions
Examining the rates of change of health indicators at the country level enables finding transition times in performance, and provides a more time-sensitive measure of country performance than does assessing performances in levels of health. The effects of changes in potential determinants of health can then be assessed in terms of their relation to transition times in performance.