Progress in health care, progress in health?

Ellen Nolte, Rembrandt D. Scholz and Martin McKee
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Ellen Nolte: London School of Hygiene and Tropical Medicine
Rembrandt D. Scholz: Rostocker Zentrum zur Erforschung des Demografischen Wandels
Martin McKee: London School of Hygiene and Tropical Medicine

Demographic Research Special Collections, 2004, vol. 2, issue 6, 139-162

Abstract: This paper examines the potential impact of changes in medical care on changing population health in Lithuania, Hungary and Romania, with west Germany included for comparison. We used the concept of deaths from certain causes that should not occur in the presence of timely and effective health care (amenable mortality) and calculated the contribution of changes in mortality from these conditions to changes in life expectancy between birth and age 75 [e (0-75)] for the periods 1980/81 to 1988 and 1992 to 1997. Temporary life expectancy improved consistently in west Germany (men: 2.7 years, women: 1.6 years). In contrast, gains were relatively small in the other countries, except among Hungarian women, who gained 1.3 years. Romanian men lost 1.3 years. In the 1980s, falling infant mortality made a substantial contribution to improvements in temporary life expectancy in all countries, of about a quarter to half a year. Of this, more than half can be attributed to amenable conditions. At older ages, falling amenable mortality contributed about 40% among those aged over 40 in Germany and, to a lesser extent, Hungary, while causing a loss of life expectancy in Romania. In the 1990s, improvements in infant mortality continued to make substantial contributions to life expectancy in Lithuania and Hungary but had little impact in either Germany or Romania. Among adults, improvements in amenable mortality continued to benefit Hungarians and west Germans. In Lithuania, up to two-thirds of the gain in temporary life expectancy were attributable to falling mortality from ischaemic heart disease whereas medical care otherwise seems to have had a negative impact. Romanian men and women experienced increases in amenable mortality that contributed up to a half of the overall loss of life expectancy. Our findings suggest that during the last 20 years changes in medical care had considerable impact, positively as well as negatively, on changing mortality in selected central and eastern European countries.

Keywords: mortality; health; Hungary; medical care; amenable mortality; Lithuania; Romania; West Germany (search for similar items in EconPapers)
JEL-codes: J1 Z0 (search for similar items in EconPapers)
Date: 2004
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (7)

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Persistent link: https://EconPapers.repec.org/RePEc:dem:drspec:v:2:y:2004:i:6

DOI: 10.4054/DemRes.2004.S2.6

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