HOW WELL IS THE ROMANIAN HEALTH SYSTEM PERFORMING? - Some progress but still some way to go -

Introduction: One of the main goals of a health system is to improve population health. In this article, we use the concept of amenable mortality to assess changes in mortality trends in the Romanian population attributable to health care over the past two decades. Methods: We used mortality data from the WHO for the period between 1996 and 2008 to calculate age-standardised mortality rates for 0-74 year olds from causes amenable to health care and assess mortality trends between 1996-2002 and 2002-2008. We compare amenable mortality rates in Romania to those for England and Wales to provide an international comparator. Results: Amenable mortality has been declining in Romania since 1996. However, detailed analysis shows that there are variations in the pace and direction of change, depending on cause and gender. Mortality rates are substantially higher in Romania compared to England and Wales for all amenable causes except for selected surgical procedures and misadventures. Conclusions: The wide gap in mortality amenable to health care in Romania compared to England and Wales points to substantial scope for improvement. However, the observation that only a modest decline has been observed since 1996 indicates that achievement of a significant improvement will be a challenge.