RATIONALE AND INTERNATIONAL EXPERIENCE IN EXCESSMORTALITY ESTIMATION

Abstract

Introduction: Dynamic assessment of mortality, as the most important indicator of health, allows us to draw conclusions
about the activity of diseases, socio-economic well-being and trends in social processes. The assessment of excess
mortality for all classes of diseases minimizes systematic errors, so it was the study of excess mortality that was proposed
half a century ago to study the consequences of influenza epidemics in different countries. The study of excess mortality, as
never occurred during the emergence of a pandemic of a new coronavirus infection, with the adoption of management
decision rules for making decisions about the occurrence of a hazard and the occurrence of an infectious agent, as well as
monitoring changes and consequences from measures and decisions aimed at preventing the spread and suppression of
Covid -19 from the side of the judiciary authorities.
Purpose of the work: review of literature data on the indicator of excess mortality.
Aim: to analyze the international experience of studying excess mortality and determine the relevance of the assessment
of excess mortality.
Search strategy: The publications search strategy included a search for literature sources on the research topic,
indexed in the databases of the electronic library e-Library, Pubmed, Web of Science, Scopus, Google Scholar. To compile
the review, publications from 1986 to 2022 were studied, the original languages were English, Russian, Chinese, Japanese,
and Spanish. The inclusion criteria were publications, and sources that indicated the study of excess mortality for all classes
of diseases; the study of excess mortality from all causes in general, as well as from individual nosologies. In total, 245
publications, sources, and official websites were analyzed, of which 94 corresponded to the objectives of the study.
Results: According to the results of our study, numerous publications show that excess mortality calculations have been
used for a long time and not only in emergency situations, but also to estimate excess deaths from various pathological
conditions and nosologies, as well as from the adverse effects of climatic and geographical conditions. There are several
ways to estimate excess mortality, each with its own characteristics. During the Covid-19 pandemic, excess mortality began
to be studied from the very first wave of this infection. Research results are highly controversial, both between countries and
within some countries. Scientists have put forward various explanations for such discrepancies, starting with the problems of
determining the initial cause of death in multimorbid pathology, and ending with different research methodologies.
Conclusions: The assessment of excess mortality has been applied in many scientific studies in healthcare, including
ecological and cohort studies. There is a growing number of papers that have studied excess mortality during the Covid-19
pandemic to determine the number of deaths attributed to the coronavirus infection. Nevertheless, the heterogeneity of the
findings warrants systematization of the methodology and statistical procedures used in studies aiming excess mortality
estimation.