Accessing free quality health care services and premature death

Int J Health Plann Manage. 2019 Apr;34(2):594-603. doi: 10.1002/hpm.2720. Epub 2018 Dec 11.

Abstract

Background: The type of health insurance may affect the likelihood of mortality of insured people. We conducted this study to determine if accessing free quality health care services could decrease the premature mortality of people in a developing country.

Methods: In a multicenter cross sectional study, "years-life-lost" (YLL) due to premature death was evaluated in 202 671 insured people residing in six large regions in Iran. The participants had access to free quality health care services. The number of insured people that died in the six regions during March 20, 2014, to March 20, 2015, as well as their sex, age, and cause of the death, were collected, and the YLL was calculated based on assumptions made in Global Burden of Disease Study 2010 (GBD2010).

Results: The crude mortality rate was 2.3 per 1000, significantly lower than the overall rate of 4.6 per 1000 people in general population of Iran. The average YLL was 47 years per 1000 persons, significantly lower than that in general population of Iran and many industrialized countries. The most common causes of death (and YLL) were cardiovascular diseases and malignancies.

Conclusion: Having access to free quality health care services is associated with a significant decrease in premature death.

Keywords: cause of death; health insurance; life expectancy; premature mortality.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Developing Countries / statistics & numerical data
  • Female
  • Health Services / supply & distribution*
  • Humans
  • Infant
  • Infant, Newborn
  • Iran / epidemiology
  • Life Expectancy
  • Male
  • Middle Aged
  • Mortality
  • Mortality, Premature*
  • Quality of Health Care / statistics & numerical data
  • Young Adult