Russian assessment methodology for estimating avoidable mortality
- Authors: Kobyakova O.S.1, Starodubov V.I.1, Avdeev S.N.2, Boytsov S.A.3, Deev I.A.4, Ivanov D.O.5, Kaprin A.D.6, Mokrysheva N.G.7, Nazarenko A.G.8, Samoylova A.V.9, Stilidi I.S.10, Chulanov V.P.11, Shamalov N.A.12, Shlyakhto E.V.13, Shport S.V.14, Marychev G.A.1,15, Shibalkov I.P.1,4, Lognenko M.M.1,16, Solomatnikov I.A.1
-
Affiliations:
- Russian Research Institute of Health
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
- National Medical Research Centre of Cardiology named after Academician E.I. Chazov
- Pirogov Russian National Research Medical University (Pirogov Medical University)
- Saint Petersburg State Pediatric University
- National Medical Research Radiological Centre
- National Medical Research Center of Endocrinology Named after Academician I.I. Dedov
- National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov
- Federal Service for Surveillance in Healthcare
- National Medical Research Center of Oncology named after N.N. Blokhin
- National Medical Research Center for Phthisiopulmonology and Infectious Diseases
- Federal Center of Brain Research and Neurotechnologies of the Federal Medical and Biological Agency of Russiа
- Almazov National Medical Research Center of the Ministry of Health of the Russian Federation
- V. Serbsky National Medical Research Centre of Psychiatry and Narcology
- HSE University
- Lomonosov Moscow State University
- Issue: Vol 80, No 4 (2025)
- Pages: 298-311
- Section: EPIDEMIOLOGY: CURRENT ISSUES
- URL: https://journals.rcsi.science/vramn/article/view/357615
- DOI: https://doi.org/10.15690/vramn18106
- ID: 357615
Cite item
Abstract
The article presents the Russian methodology for assessing avoidable mortality. Based on the analysis of existing scientific data and approaches of other countries to the definition of preventable mortality, the criteria of preventable mortality, taking into account the peculiarities of the Russian health care system, are proposed. The criteria were developed jointly with leading federal experts in the field of health care, including chief non-staff specialists of the Ministry of Health of Russia. The upper age limit of avoidable mortality was defined and set at 78 years, which corresponds to the national development goals of the Russian Federation. The methodology includes 147 items for various causes of death and provides for the division of avoidable mortality into preventable and treatable mortality, specifying the proportions for 17 groups of causes of death. The concept of avoidable mortality is presented as a way of assessing the quality and objective capabilities of the health care system. Therefore, the methodology can be used as a tool for assessing the quality of medical care, an indicator of the effectiveness of preventive measures and a marker of progress in achieving the national goal of improving public health. The introduction of the methodology will make it possible to identify priority areas of prevention, assess the effectiveness of treatment and diagnostic measures, monitor the dynamics of avoidable mortality and form targeted programmes to reduce mortality, as well as to identify realistic reserves for reducing mortality by reducing avoidable mortality. In particular, it seems necessary to study avoidable mortality in the regional context, which will make it possible to assess not only the national reserves of mortality reduction, but also individual reserves for each region. At the same time, the analysis of regional differences in avoidable mortality will help to better understand the factors of interregional differences in mortality in general.
Full Text
##article.viewOnOriginalSite##About the authors
Olga S. Kobyakova
Russian Research Institute of Health
Email: kobyakovaos@mednet.ru
ORCID iD: 0000-0003-0098-1403
SPIN-code: 1373-0903
MD, PhD, Professor, Corresponding Member of the RAS
Russian Federation, MoscowVladimir I. Starodubov
Russian Research Institute of Health
Email: starodubov@mednet.ru
ORCID iD: 0000-0002-3625-4278
SPIN-code: 7223-9834
MD, PhD, Professor, Academician of the RAS
Russian Federation, MoscowSergey N. Avdeev
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Email: avdeev_s_n@staff.sechenov.ru
ORCID iD: 0000-0002-5999-2150
SPIN-code: 1645-5524
MD, PhD, Professor, Academician of the RAS
Russian Federation, MoscowSergey A. Boytsov
National Medical Research Centre of Cardiology named after Academician E.I. Chazov
Email: prof.boytsov@gmail.com
ORCID iD: 0000-0001-6998-8406
SPIN-code: 7961-5520
MD, PhD, Professor, Academician of the RAS
Russian Federation, MoscowIvan A. Deev
Pirogov Russian National Research Medical University (Pirogov Medical University)
Email: kafedra-rgmu@mail.ru
ORCID iD: 0000-0002-4449-4810
SPIN-code: 2730-0004
MD, PhD, Professor
Russian Federation, MoscowDmitry O. Ivanov
Saint Petersburg State Pediatric University
Email: spb@gpmu.org
ORCID iD: 0000-0002-0060-4168
SPIN-code: 4437-9626
MD, PhD, Professor
Russian Federation, Saint PetersburgAndrey D. Kaprin
National Medical Research Radiological Centre
Email: mnioi@mail.ru
ORCID iD: 0000-0001-8784-8415
SPIN-code: 1759-8101
MD, PhD, Professor, Academician of the RAS
Russian Federation, MoscowNatalia G. Mokrysheva
National Medical Research Center of Endocrinology Named after Academician I.I. Dedov
Email: mokrisheva.natalia@endocrincentr.ru
ORCID iD: 0000-0002-9717-9742
SPIN-code: 5624-3875
MD, PhD, Professor, Academician of the RAS
Russian Federation, MoscowAnton G. Nazarenko
National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov
Email: cito@cito-priorov.ru
ORCID iD: 0000-0003-1314-2887
SPIN-code: 1402-5186
MD, PhD, Professor, Corresponding Member of the RAS
Russian Federation, MoscowAlla V. Samoylova
Federal Service for Surveillance in Healthcare
Email: allasamoi@mail.ru
ORCID iD: 0000-0003-0542-9503
SPIN-code: 7241-8369
MD, PhD, Professor
Russian Federation, MoscowIvan S. Stilidi
National Medical Research Center of Oncology named after N.N. Blokhin
Email: ronc@list.ru
ORCID iD: 0000-0002-0493-1166
SPIN-code: 9622-7106
MD, PhD, Professor, Academician of the RAS
Russian Federation, MoscowVladimir P. Chulanov
National Medical Research Center for Phthisiopulmonology and Infectious Diseases
Email: chulanov_v_p_1@staff.sechenov.ru
ORCID iD: 0000-0001-6303-9293
SPIN-code: 2336-4545
MD, PhD
Russian Federation, MoscowNikolay A. Shamalov
Federal Center of Brain Research and Neurotechnologies of the Federal Medical and Biological Agency of Russiа
Email: shamalov@fccps.cl
ORCID iD: 0000-0001-6250-0762
SPIN-code: 2865-9817
MD, PhD
Russian Federation, MoscowEvgeny V. Shlyakhto
Almazov National Medical Research Center of the Ministry of Health of the Russian Federation
Email: e.shlyakhto@almazovcentre.ru
ORCID iD: 0000-0003-2929-0980
SPIN-code: 6679-7621
MD, PhD, Academician of the RAS
Russian Federation, MoscowSvetlana V. Shport
V. Serbsky National Medical Research Centre of Psychiatry and Narcology
Email: info@serbsky.ru
ORCID iD: 0000-0003-0739-4121
SPIN-code: 2926-9305
MD, PhD
Russian Federation, MoscowGleb A. Marychev
Russian Research Institute of Health; HSE University
Author for correspondence.
Email: marychevga@mednet.ru
ORCID iD: 0009-0006-7737-0781
MD, PhD Student
Russian Federation, Moscow; MoscowIvan P. Shibalkov
Russian Research Institute of Health; Pirogov Russian National Research Medical University (Pirogov Medical University)
Email: shibalkovip@mednet.ru
ORCID iD: 0000-0002-4255-6846
SPIN-code: 6341-3247
PhD in Economics, Associate Professor
Russian Federation, Moscow; MoscowMariia M. Lognenko
Russian Research Institute of Health; Lomonosov Moscow State University
Email: lognenkomm@mednet.ru
ORCID iD: 0009-0009-1469-4588
Student
Russian Federation, Moscow; MoscowIvan A. Solomatnikov
Russian Research Institute of Health
Email: solomatnikovia@mednet.ru
ORCID iD: 0000-0002-7013-9054
SPIN-code: 7071-1095
Russian Federation, Moscow
References
- Указ Президента РФ от 7 мая 2024 г. «О национальных целях развития Российской Федерации на период до 2030 года и на перспективу до 2036 года». [Ukaz Prezidenta RF ot 7 maya 2024 g. “O nacional’nyh celyah razvitiya Rossijskoj Federacii na period do 2030 goda i na perspektivu do 2036 goda”. (In Russ.)] Available from: http://kremlin.ru/events/president/news/73986 (accessed: 07.04.2025).
- OECD. Health at a Glance 2023: OECD Indicators]. OECD; 2023 (Health at a Glance). Available from: https://www.oecd.org/en/publications/health-at-a-glance-2023_7a7afb35-en.html (accessed: 14.07.2025).
- Kossarova L, Holland W, Nolte E, et al. Measuring “avoidable” mortality: methodological note. Brussels, Belgium: Directorate-General “Employment, Social Affairs and Equal Opportunities”; 2009. Available from: http://ec.europa.eu/social/home.jsp (accessed: 01.07.2024).
- OECD/Eurostat. Avoidable mortality: OECD/Eurostat lists of preventable and treatable causes of death (January 2022 version). Available from: https://www.oecd.org/content/dam/oecd/en/data/datasets/oecd-health-statistics/avoidable-mortality-2019-joint-oecd-eurostat-list-preventable-treatable-causes-of-death.pdf (accessed: 14.07.2025).
- Australian Institute of Health and Welfare & National Indigenous Australians Agency. AIHW Indigenous HPF. 2022. Measure 1.24 Avoidable and preventable deaths, Aboriginal and Torres Strait Islander Health Performance Framework website. Available from: https://www.indigenoushpf.gov.au/measures/1-24-avoidable-and-preventable-deaths (accessed: 01.07.2024).
- Canadian Institute for Health Information. Avoidable Deaths. Available from: https://www.cihi.ca/en/indicators/avoidable-deaths (accessed: 01.07.2024).
- Office for National Statistics. Avoidable mortality in England and Wales Statistical bulletins. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/avoidablemortalityinenglandandwales/previousReleases (accessed: 01.07.2024).
- Rutstein DD, Berenberg W, Chalmers TC, et al. Measuring the quality of medical care. A clinical method. N Engl J Med. 1976;294(11):582–588. doi: https://doi.org/10.1056/NEJM197603112941104
- Charlton JRH, Hartley RM, Silver R, et al. Geographical variation in mortality from conditions amenable to medical intervention in England and Wales. Lancet. 1983;1(8326Pt 1):691–696. doi: https://doi.org/10.1016/S0140-6736(83)91981-5
- Holland WW. (ed.) European Community atlas of “avoidable death”. Oxford: Oxford University Press; 1988.
- Holland WW. (ed.) European Community atlas of “avoidable death”. 2nd ed. Oxford-N.Y.: Oxford University Press; 1991.
- Holland WW. (ed.) European Community atlas of “avoidable death”. 1985–1989. 3rd ed. Oxford: Oxford University Press; 1997.
- Определение приоритетов развития здравоохранения на федеральном и региональном уровнях на основе обобщенной оценки преждевременной и предотвратимой смертности населения: методические указания / Министерство здравоохранения Российской Федерации. — М., 2001. [Opredelenie prioritetov razvitija zdravoohranenija na federal’nom i regional’nom urovnjah na osnove obobshhennoj ocenki prezhdevremennoj i predotvratimoj smertnosti naselenija: Metodicheskie ukazanija / Ministerstvo zdravoohranenija Rossijskoj Federacii. Moskva; 2001. (In Russ.)]
- Andreev EM, Nolte E, Shkolnikov VM, et al. The evolving pattern of avoidable mortality in Russia. Int J Epidemiol. 2003;32(3):437–446. doi: https://doi.org/10.1093/ije/dyg085
- Предотвратимая смертность в России и пути ее снижения / науч. ред. Ю.В. Михайлова, А.Е. Иванова. — М.: ЦНИИОИЗ, 2006. — 251 c. [Predotvratimaja smertnost’ v Rossii i puti ee snizhenija / nauch. red. Mihajlova JuV, Ivanova AE. Moskva: CNIIOIZ; 2006. 251 s. (In Russ.)]
- Сон И.М., Леонов С.А., Вайсман Д.Ш. Автоматизированная система регистрации смертности: оценка предотвратимой смертности // Социальные аспекты здоровья населения. — 2014. — Т. 35. — № 1. — С. 1. [Son IM, Leonov SA, Vajsman DSh. The automated system of death registration: assessment of preventable mortality. Social Aspects of Population Health. 2014;35(1):1. (In Russ.)]
- Сабгайда Т.П., Антонюк В.В., Евдокушкина Г.Н., и др. Предотвратимая смертность населения // Осипов Г.В., Рязанцев С.В. (ред.) Демографические перспективы России. — М.: Экон-Информ, 2008. — С. 373–394. [Sabgaida TP, Antonyuk VV, Evdokushkina GN, et al. Preventable mortality of the population. In: Osipov GV, Rjazancev SV. (eds) Demographic perspectives Russia. Moskow: Ekon-Inform; 2008. P. 373–394. (In Russ.)]
- Сабгайда Т.П., Аксенова Е.И., Евдокушкина Г.Н. Предотвратимая смертность населения трудоспособного возраста // Рязанцев С.В., Ростовская Т.К. (ред.) Национальные демографические приоритеты: новые подходы, тенденции. — М., 2019. — С. 187–190. [Sabgaida TP, Aksenova EI, Evdokushkina GN. Preventable mortality of the working-age population. In: Ryazantsev SV, Rostovskaya TK. (eds) National demographic priorities: new approaches, trends. Moscow; 2019. P. 187–190. (In Russ.)]
- Иванова А.Е., Семенова В.Г., Сабгайда Т.П. Резервы снижения смертности в России, обусловленные эффективностью здравоохранения // Вестник Российской академии наук. — 2021. — Т. 91. — № 9. — C. 865–878. [Ivanova AE, Semjonova VG, Sabgajda TP. Rezervy snizhenija smertnosti v Rossii, obuslovlennye jeffektivnost’ju zdravoohranenija. Vestnik Rossijskoj akademii nauk. 2021;9(91):865–878. (In Russ.)] doi: https://doi.org/10.31857/S086958732109005X
- Сабгайда Т.П., Михайлов Я.Ю. Новые подходы к оценке предотвратимой смертности в России // Народонаселение. — 2009. — № 3. — С. 115–122. [Sabgajda TP, Mihajlov JaJu. Novye podhody k ocenke predotvratimoj smertnosti v Rossii. Narodonaselenie. 2009;3:115–122. (In Russ.)]
- Nolte E, McKee M. Does health care save lives? Avoidable mortality revisited. London: Nuffield Trust; 2004.
- Nolte E, McKee CM. Measuring the health of nations: updating an earlier analysis. Health Aff (Millwood). 2008;27(1):58–71. doi: https://doi.org/10.1377/hlthaff.27.1.58
- Иванова А.Е., Сабгайда Т.П., Семенова В.Г., и др. Оценка деятельности здравоохранения с использованием критериев предотвратимой смертности // Здоровье мегаполиса. — 2022. — Т. 3. — № 1. — C. 41–52. [Ivanova AE, Sabgaida TP, Semenov VG, et al. Health Performance Evaluation using preventable mortality criteria. City Healthcare. 2022;3(1):41–52. (In Russ.)]
- Зубко А.В., Сабгайда Т.П., Семенова В.Г., и др. Потери российского населения от предотвратимых причин сердечно-сосудистой смертности в периоды до и во время пандемии // Социальные аспекты здоровья населения. — 2023. — Т. 69. — № 1. — С. 6. [Zubko AV, Sabgaida TP, Semyonova VG, et al. Mortality associated with preventable causes of deaths from cardio-vascular diseases in the pre-covid period and during the pandemic in Russia. Social Aspects of Population Health. 2023;69(1):6. (In Russ.)] doi: https://doi.org/10.21045/2071-5021-2023-69-1-6
- Nikoloski Z, Shkolnikov VM, Mossialos E. Preventable mortality in the Russian Federation: a retrospective, regional level study. Lancet Reg Health Eur. 2023;29:100631. doi: https://doi.org/10.1016/j.lanepe.2023.100631
- Frick C, Rumgay H, Vignat J, et al. Quantitative estimates of preventable and treatable deaths from 36 cancers worldwide: a population-based study. Lancet Glob Health. 2023;11(11):e1700–e1712. doi: https://doi.org/10.1016/S2214-109X(23)00406-0
- Simonato L, Ballard T, Bellini P, et al. Avoidable mortality in Europe 1955–1994: a plea for prevention. J Epidemiol Community Health. 1998;52(10):624–630. doi: https://doi.org/10.1136/jech.52.10.624
- Frenk J, Bobadilla JL, Sepuúlveda J, et al. Health transition in middle-income countries: new challenges for health care. Health Policy and Planning. 1989;4(1):29–39. doi: https://doi.org/10.1093/heapol/4.1.29
- Frenk J, Bobadilla JL, Stern C, et al. Elements for a theory of the health transition. Health Transit Rev. 1991;1(1):21–38.
Supplementary files

