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The main objective of the thesis is the evaluation of the development of avoidable mortality in selected European countries during 1980-2010 with emphasis on comparison of East and West. Concept of avoidable mortality was established to measure the effectiveness of the health care system in 70s of the past century. The main results of the thesis indicate different development of avoidable mortality during 80s in both parts of Europe. Inefficient medical care and inappropriate health policy in formal Eastern Bloc contributed to divergent trends of avoidable mortality in Europe. Different trends of mortality were observed in East European countries especially during the transformation process. The importance of selection of avoidable causes and age limits was confirmed. Powered by TCPDF (www.tcpdf.org)

La progression de l’espérance de vie au Québec reflète l’amélioration de la santé de la population. Toutefois, des décès continuent à survenir prématurément avant l’âge de 75 ans. Une part de cette mortalité prématurée est potentiellement évitable. L'objectif de ce mémoire est d’estimer la mortalité évitable au Québec de 1981-1985 à 2005-2009. Pour cela, la méthode de Tobias et Jackson (2001) a été appliquée sur des données de décès, fournies par l’Institut national de santé publique du Québec, pour estimer les taux de mortalité évitable totale et pour chacun des sexes. Cette approche nous a, par ailleurs, permis d’estimer des taux de mortalité évitable selon trois paliers de prévention : primaire, secondaire et tertiaire. Nos résultats démontrent une tendance à la baisse de la mortalité évitable à travers le temps. Cette baisse a été enregistrée chez les deux sexes, mais des disparités de mortalité évitable existent entre les hommes et les femmes. En effet, la mortalité évitable des hommes est plus élevée que celle des femmes et cet écart de mortalité est principalement dû à la mortalité évitable associée à la prévention primaire. L’analyse de la mortalité évitable par cause de décès fait ressortir que le cancer du poumon est la principale cause de décès évitable tant chez les hommes que chez les femmes en 2005-2009. Durant cette même période, le cancer du sein et les cardiopathies ischémiques étaient la deuxième cause de décès évitable respectivement chez les femmes et chez les hommes. / The upward trend observed in Quebec’s life expectancy in past years suggests that population health has continued to improve. However, a number of deaths continue to occur prematurely before the age of 75 years. A part of this premature mortality is potentially avoidable. The objective of this paper is to estimate avoidable mortality rates in Quebec from 1981-1985 to 2005-2009. Avoidable mortality rates were obtained by applying the method of Tobias and Jackson (2001) to mortality data made available to us by the Institut national de santé publique du Québec. Furthermore, this approach allowed us to evaluate avoidable mortality rates by three levels of prevention: primary, secondary and tertiary. Our results show a downward trend in avoidable mortality from 1981-1985 to 2005-2009. This decline was observed for the whole population and also for both sexes. Differences in male’s and female’s avoidable mortality trends are however noticed. Indeed, avoidable mortality is higher for men than women and a large part of this difference is associated to primary prevention. The analysis by cause of death revealed that lung cancer was the leading cause of avoidable death in both men and women in 2005-2009. During this same period, the second leading cause of avoidable mortality is breast cancer and ischemic heart diseases in females and males respectively.

Analysis of mortality development in Russia using various decomposition methods Abstract The aim of this thesis is to analyze and evaluate mortality development in Russia in last 50 years by using various decomposition methods. The first part presents the method of decomposition of the difference between two demographic indicators (E. Kitagawa's method or methods from E. Arriaga, R. Pressat and J. Pollard). In the second part mortality development in Russia is analyzed by using methods that decomposed the value of demographic indicators in a given year. Mortality is divided into senescent and background component by using the Gompertz-Makeham formula and by using the logistic model. Afterwards, avoidable and unavoidable mortality and mortality due to endogenous and exogenous causes of death is analyzed. Hypotheses, set out in the introductory chapter, are verified by using different decomposition methods. Using multiple methods of decomposition enable to obtain a more complex view of the evolution of mortality in the observed period so that could be viewed from multiple perspectives and identify specific population trends in Russia. Keywords: mortality, Russia, decomposition, senescent and background mortality, avoidable mortality, endogenous, exogenous, causes of death, mortality crisis

Kazakhstan: Mortality in European context (comparison with selected European countries and nationalities) Abstract The aim of this diploma thesis is to anylized mortality rates in Kazakhstan and compared it with selected European countries. In the begining of the thesis is brief outline of history and development of ethnic composition in this Central Asian Republic. Another section contains a comparison of the economic and social conditions in Kazakhstan with two selected European countries - the Czech Republic and Sweden. The thesis continues with comparison and development of the most important mortality indicators in the three above mentioned countries. One of the used criteria summarizes findings from the comparison of mortality backgrounds of three selected European minorities living in Kazakhstan (Germans, Russians and Ukrainians) with their country of origin. This comparison shows a big difference for German nationality, for Russians and Ukrainians the differences are minimal. The concept of avoidable mortality was also used for comparison mortality conditions in selected countries. The results show a low level of health care system in Kazakhstan. The analysis shows a clear gap in Kazakhstan levels of mortality in comparison with selected European countries and nations. Keywords: Kazakhstan, The...

The aim of this thesis is to map regional variability in the intensity of mortality using methods avoidable mortality and a few selected characteristics of health care. The thesis describes the development of the concept of avoidable mortality, which is then used for the Czech Republic for the period 2006-2010 and to individual districts for the period 2006-2010. Furthermore, this thesis focuses on the relationship between expenditures of General Health Insurance Company and the level of mortality in the regions. For showing regional differences depending on the health care intensity of mortality from ischemic heart disease (both acute and chronic forms) was also selected, depending on the distance of specialized medical care. The last chapter focuses on National screening programs and cancer mortality, which are integrated in a comparison of the percentage of people examine in this program for districts. The relationship between spending per insured and intensity of mortality and outcomes related to the intensity of mortality, depending on the availability of specialized health care has been confirmed by statistical methods - correlation (Pearson correlation coefficient). Relationship between the intensity of mortality in cancer within screening programs and the percentage of people who passed...