Rationale
Avoidable mortality indicators provide additional insight into the Canadian health system. These measures can be used to assess the impact of prevention strategies and the outcomes of health policy decisions and health care provision.
The potentially avoidable mortality indicator includes premature deaths that could be avoidable through all levels of prevention.
Mortality from preventable causes focuses on premature deaths from conditions that could potentially be avoided through primary prevention efforts, such as lifestyle modifications or population-level interventions (for example, vaccinations and injury prevention). The indicator informs efforts aimed at reducing the number of initial cases, or incidence reduction, as deaths are prevented by avoiding new cases altogether.
Mortality from treatable causes focuses on premature deaths that could potentially be avoided through secondary and tertiary prevention efforts, such as screening for and effective treatment of an existing disease. The indicator informs efforts aimed at reducing the number of people who die once they have the condition, or case-fatality reduction.
Avoidable mortality indicators can serve to inform where Canada's health system has made gains and to point to where more work is needed. They can also help to quantify potential gains. For example, in an ideal world where all avoidable mortality in Canada has been eliminated, life expectancy at birth for the years 2006 to 2008 would have been 85.8 years—4.9 years longer than the actual life expectancy of 80.9 years. Three of the 4.9 years would be attributed to eliminating preventable mortality; the other 1.9 years would come from eliminating mortality from treatable causes.
Analysis of avoidable mortality highlights the need for prevention.
Interpretation
Lower rates are desirable.
Comments
The indicator is calculated based on 3 years of pooled data.
Avoidable mortality indicators were developed based on the Australian Potentially Avoidable Deaths indicator and the U.K. Office for National Statistics' list of causes of avoidable mortality, followed by expert review of the diagnosis codes and rationales for including each condition.
Causes of death were assigned to preventable and treatable subcategories based on 2 main mechanisms of mortality reduction: incidence and case-fatality reduction. These subcategories are mutually exclusive. In cases where a prevention/treatment overlap exists, the case was assigned to the preventable category; the exceptions were ischemic heart disease and stroke, where a random half of cases were assigned as preventable and the other half assigned as treatable. However, the mutually exclusive nature of the subcategories does not imply that all cases assigned to the preventable group do not have a treatable component, and vice versa.
More information about the indicator can be found in the In Focus section of Health Indicators 2012, available on CIHI's website.
Indicator results are also available on