Measuring avoidable deaths and diseases in New York State

Area of Science:

• Public Health
• Health Services Research
• Preventive Medicine

Background:

• Sentinel health events (SHEs) are indicators of community health and healthcare system performance.
• A framework exists for identifying SHEs, encompassing over 120 preventable or manageable conditions.
• Hospital discharge data provide valuable insights into avoidable negative health outcomes.

Purpose of the Study:

• To assess the burden of potentially avoidable deaths and diseases in New York State using sentinel health event methodology.
• To identify specific conditions contributing significantly to avoidable mortality and morbidity.
• To examine disparities in sentinel health events among different demographic and socioeconomic groups.

Main Methods:

• Analysis of Statewide Planning and Research Cooperative System (SPARCS) hospital discharge abstract data from New York State for 1983.
• Identification and quantification of sentinel health events, categorized as potentially avoidable or partially avoidable.
• Comparison of sentinel event rates across racial, insurance, and hospital type groups.

Main Results:

• Over 19,000 potentially avoidable deaths and over 336,000 potentially preventable disease instances were identified in hospitalized New York residents in 1983.
• Lung cancer, emphysema/COPD, and bladder cancer accounted for 75% of deaths and 60% of diseases in the "each event avoidable" category.
• Vascular complications of hypertension were linked to 45% of deaths in the "some proportion avoidable" category.
• Significantly higher rates of many sentinel events were observed among Black individuals, Medicaid recipients, and public hospital users, with Black patients having over double the mortality for colon neoplasms.

Conclusions:

• Sentinel health event analysis of hospital discharge data reveals a substantial burden of preventable mortality and morbidity in New York State.
• Specific conditions like lung cancer, COPD, bladder cancer, and hypertensive vascular complications represent critical targets for intervention.
• Significant health disparities exist, highlighting the need for targeted public health strategies and healthcare improvements for vulnerable populations.