Health services resources and their relation to mortality from causes amenable to health care intervention: a cross-national study.

Gross national product has been found to be negatively associated with age-specific mortality, and the prevalence of medical doctors positively associated with mortality in younger age groups. We studied the relationship between mortality and its determinants among people aged 64 years or less in 25 developed countries. Age-adjusted mortality rates from causes of death amenable to interventions by health services were calculated for the period 1975-8, and, likewise, rates from partly amenable causes, non-amenable causes, and violent causes of death. In regression analysis, log mortality from amenable causes was significantly negatively associated with gross domestic product (GDP) but not with the numbers of medical doctors, nurses and midwives, hospital beds, alcohol consumption, tobacco consumption, or military expenditure. It is argued that cross-sectional comparisons disguise the effects of health services on mortality.