GEOGRAPHIC-DISTRIBUTION OF AVOIDABLE MORT ALITY IN THE COMMUNITY OF VALENCIA, SPAIN (1975-1990)

BACKGROUND: Avoidable mortality (AM) has been proposed as the indicato r of the quality and the efficacy of health care services and a parame ter useful to distribute health care resources. The aim of this study was to analyze the size and geographic variability of AM in the Commun ity of Valencia, Spain (1975-1990). METHODS: The causes of AM were ana lyzed by the classification of Holland divided into indicators of medi cal care (IMC) and indicators on national health care policy (INHCP) i n addition to the causes of the Charlton classification. Standard rate s for Spain and the European Community, the rate of masculinity and co ntribution to total mortality were calculated. Geographic distribution by areas and provinces was analyzed by the rate of standardized morta lity. RESULTS: According to the Holland classification AM was 30% of t he deaths from 5 to 64 years of age. Out of these cases, 18.5% corresp onded to INHCP and 11.1% to IMC. According to the Charlton classificat ion, this percentage was 3.6%. A considerable variation was observed a mong the 20 areas analyzed due to many causes. The geographic distribu tion by groups (IMC, INHCP and the Charlton classification) is quite h omogeneous. The worse results corresponded to the city of Valencia and to the area 21 (area of the city of Alicante). CONCLUSIONS: A great v ariation was found in the results regarding geographic distribution fo r individual causes of death while the distribution was quite homogene ous for all of the groups of mortality with the worst results being ob served in large urban centers.