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Progress in health care, progress in health?

Author

Listed:
  • 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)

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.

Suggested Citation

  • Ellen Nolte & Rembrandt D. Scholz & Martin McKee, 2004. "Progress in health care, progress in health?," Demographic Research Special Collections, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 2(6), pages 139-162.
    • Handle: RePEc:dem:drspec:v:2:y:2004:i:6
    DOI: 10.4054/DemRes.2004.S2.6
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    References listed on IDEAS

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    1. Jeff Powell, 2012. "International finance," Chapters, in: Jan Toporowski & Jo Michell (ed.), Handbook of Critical Issues in Finance, chapter 24, pages i-ii, Edward Elgar Publishing.
    2. Koupilova, Ilona & McKee, Martin & Holcik, Jan, 1998. "Neonatal mortality in the Czech Republic during the transition," Health Policy, Elsevier, vol. 46(1), pages 43-52, October.
    3. repec:cai:popine:popu_p1985_40n4-5_0770 is not listed on IDEAS
    4. Eduardo Arriaga, 1984. "Measuring and explaining the change in life expectancies," Demography, Springer;Population Association of America (PAA), vol. 21(1), pages 83-96, February.
    Full references (including those not matched with items on IDEAS)

    Citations

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    Cited by:

    1. Mackenbach, Johan P. & Hu, Yannan & Looman, Caspar W.N., 2013. "Democratization and life expectancy in Europe, 1960–2008," Social Science & Medicine, Elsevier, vol. 93(C), pages 166-175.
    2. Nataliia Levchuk, 2009. "Alcohol and mortality in Ukraine," MPIDR Working Papers WP-2009-017, Max Planck Institute for Demographic Research, Rostock, Germany.
    3. Lucia Bosakova & Katarina Rosicova & Daniela Filakovska Bobakova & Martin Rosic & Dagmar Dzurova & Hynek Pikhart & Michala Lustigova & Paula Santana, 2019. "Mortality in the Visegrad countries from the perspective of socioeconomic inequalities," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(3), pages 365-376, April.
    4. Enkelejda AVDI, 2013. "The System Of Contributions For Health Insurance Scheme In Albania - Performance And Main Challenges," Regional Science Inquiry, Hellenic Association of Regional Scientists, vol. 0(2), pages 99-110, December.
    5. Johan Mackenbach & Caspar Looman, 2013. "Changing patterns of mortality in 25 European countries and their economic and political correlates, 1955–1989," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(6), pages 811-823, December.
    6. Yuka S. Minagawa, 2018. "Changing Life Expectancy and Health Expectancy Among Russian Adults: Results from the Past 20 Years," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 37(5), pages 851-869, October.
    7. Adriana Castelli & Olena Nizalova, 2011. "Avoidable mortality: what it means and how it is measured," Working Papers 063cherp, Centre for Health Economics, University of York.

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    More about this item

    Keywords

    mortality; health; Hungary; medical care; amenable mortality; Lithuania; Romania; West Germany;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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