DOI: 10.21045/2071-5021-2017-57-5-2 

Sabgayda T.P., Semenova V.G.
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow

Contacts: Sabgayda Tamara, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Sabgayda T.P., http://orcid.org/0000-0002-5670-6315
Semenova V.G., http://orcid.org/0000-0002-2794-1009
Acknowledgments. The study had no sponsorship.
Conflct of interests. The authors declare no conflict of interest.

Abstract

Significance. From 2013 to 2015, cardiovascular mortality declined by 10% among men and by 13.1% among women, with a drop in all-cause mortality by 3.0% among men and an increase of 0.4% among women in Russia. In this connection, the question arises: are trends in mortality from other classes of diseases consistent with changes in vascular mortality?

The purpose of the study was to check the reliability of the rate of reduction in mortality from diseases of the circulatory system comparing it with the rate of change in mortality from noncommunicable diseases in different age groups of adult population.

Methods. Standardized mortality of the Russian population in 1999-2015 was analyzed according to official statistics with a breakdown on different age groups of men and women: 30-44, 45-59, 60-74, 75 years and over. In addition to circulatory diseases, the analysis was carried out for those classes of diseases for which the death rate increased by more than 10% from 2013 to 2015.

Change in the mean age of death from those diseases was calculated for the period from 2013 to 2015. Mortality projections for 2014 and 2015 were constructed based on trends estimated according to data for the previous period. Using the obtained discrepancies between the predicted and observed mortality values, the volume of cases of over-diagnoses of the analyzed death causes was calculated, and then compared with the estimated number of "under-registered" cardiovascular deaths for the total population and the oldest age group of 75 and over.

Results. From 2013 to 2015 there was a decrease in the average age of those who died from diseases of the circulatory system by 0.3 years. It increased for diabetes by 2.1 years, for diseases of the nervous system and mental disorders - by 9.8 years, for diseases of the genitourinary system –by 2.4 years, for diseases of the musculoskeletal system - by 9.0 years. In 2014, the difference between the number of cases that are missing in comparison with the predicted number of cardiovascular deaths, and the number of cases that are additional for the remaining death causes equaled to 1.9 times for men and 1.6 times for women, in 2015 it added up to 4.5 and 2.3 times respectively. For the oldest age group, those indices were 0.8, 1.1, 1.1, and 1.4 times, respectively.

Conclusions. 1. Extremely high rates of reduction in cardiovascular mortality are artificial: there is a controlled transfer of cases that were coded as deaths from diseases of the circulatory system within the previous practice of coding until 2013, to other classes of death causes.

2. The target group for "correcting" death causes is population of the oldest age group. 3. When monitoring the target program indicator, it is necessary to implement an ongoing verification of its measurement.

Keywords: rate of reduction in cardiovascular mortality; mortality forecasting; average age of death; quality of diagnosis of death causes; regulation of target indicator of a program.

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