Mortalità evitabile

[Autom. eng. transl.] Mortality attributable to health services (amenable mortality related to health care services) includes those "deaths considered premature, which should not occur in the presence of appropriate and timely care" (1). In other words, it includes those "deaths attributable to conditions for which effective diagnostic-therapeutic interventions exist, which could reduce premature deaths" (2). This definition represents an evolution of the concept of avoidable mortality, developed in the United States in the seventies (3), which referred to causes of death responding both to health promotion and primary prevention actions, and to diseases susceptible to effective treatments. The avoidable mortality therefore reflects the action of determinants that go beyond the competence of the health services, as conventionally defined. Thanks to the studies of Nolte and McKee (NMK) and of Tobias and Yeh (TY) (4, 2), the concept of Mortality Amenable (MA) has been brought to the attention of the scientific community as a potential tool to assess quality and the effectiveness of health systems and to monitor changes over time. Recently, the Organization for Economic Cooperation and Development (OECD) and the English Department of Health have adopted this indicator to assess the performance of health systems in various countries (5).