Avoidable death as a measure of quality

Age standardized mortality rates (SMR) vary between 43 and 162 per 100,000 inhabitants from cervical cancer in different areas in England, between 19 and 250 from tuberculosis, between 31 and 249 for asthma, between 0 and 263 from rheumatic heart disease, from 0 to 379 for acute respiratory disease, from 18 to 279 for abdominal hernias, and from 0 to 228 for appendicitis. Essentially similar differences were found for some of these diseases between five EEC countries. Many differences persist when correlated against social variables, and high quality health services should respond to possible differences in incidence. Reasons for so-called avoidable mortality vary. In cervical cancer failure to include high risk groups in screening programmes or failure to follow up screening results have been encountered, in hypertensive disease, failure of follow up.