A comparison of avoidable mortality in Lithuania and Sweden 1971-1990

In reforming the Lithuanian health care system it is important to evaluate the health status of the population and the outcome of health care by comparison to Western European countries. The aim of this study is to examine the possibility of comparing data on avoidable mortality in Lithuania with Sweden and, when realistic, to compare avoidable mortality rates between Lithuania and Sweden.

Comparisons were made for the time period 1971-1990. During this period a basic tabulation list including 200 groups of causes of death modified from WHO's International Classification of Diseases was obligatory for all Soviet Republics. This limited the opportunity for comparisons with Western European countries. However, for most of the selected avoidable death indicators comparisons with Sweden were made possible by slightly modifying the indicators.

In the age group 5-64 years in 1971-1975 the total mortality in Lithuania was 60% higher than that in Sweden. In 1986-1990 this gap had increased to 90%. For most avoidable death indicators the difference was even greater, i.e. the death rate in Lithuania was several times higher than that in Sweden. For instance, death rates for tuberculosis were 36 times higher and for appendicitis, cholelithiasis and cholecystitis six times higher in Lithuania. For several avoidable causes of death, such as tuberculosis, appendicitis and hypertensive and cerebrovascular disease the gap widened during the study period.

The results indicate potential fields for improvement of the health care system in Lithuania. The importance of implementing international classification systems for epidemiological surveillance of the outcome of health care is stressed.