| Summary: | 碩士 === 國立成功大學 === 公共衛生研究所 === 97 === Background: League table by city/county is a commonly used statistics by mass media and health authorities to identify health problems and assess the performance. However, it is controversial in choosing which cause of death (COD) for comparisons. In addition, the interpretation of league table might be incorrect if we did not consider the statistical unstabability due to population size.
Objective: To identify avoidable cause of death suitable for league table by city/county in Taiwan and to compare the conclusions derived from traditional ranking method with those considering the 95% confidence intervals (95% CI).
Materials and methods: The criteria used in identifying suitable avoidable COD are the frequence of use by previous studies and number of deaths in Taiwan. We then calculated the age-adjusted mortality rate of each city/county for different age-group ranges (0-75 and 0-69 years) for 1998-2007 and 1988-1997, percentage of chages between the two periods and 95% CI. The 25th and 75th percentile were used as the cutpoint in identifying the size of problem.
Results: Of more than 80 avoidable COD, we identify 10 COD suitable for city/county level comparisons. Of the top and lower five city/counties identified according to traditional ranking method; on avearge two to three of them would be excluded if we considered the 95% CI. Most of the city/counties been excluded were those with small population such as Penghu County, Keelung City, Hsing-Chu City and Chiayi City .We also found that the ranks of mortality for the years 1998-2007 differed greatly from the ranks of changes of mortality from 1988-1997 to 1998-2007.
Conclusions: To have a proper interpretation of league table in identifying important health problems and assessing performace, we should confine to those avoidable COD with significant number of deaths in certain age-group range and taking into account the 95% CI and percentage of changes.
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