背景：可避免死因是指在現有醫療照護體系下，有些死亡是可以避免的。可避免死因死亡率常被當作一個國家或地區健康體系績效的哨兵指標，啟動進一步評估。縣市是台灣健康體系地方自治單位，可惜過去沒有縣市別的可避免死因死亡率分析。
目的：探討台灣可避免死因死亡率趨勢與縣市地區不平等的趨勢。
方法：死因統計由衛生福利部統計處的開放資料集獲得，可避免死因定義依照國際經濟合作發展組織與歐盟統計2019 年版本定義進行部分調整。首先是台灣為單位的逐年趨勢，以連結點迴歸模式估算年改變率來呈現。接著分析不同年代（2008-2010，2011-2013，2014-2016 與2017-2019）縣市不平等趨勢。第三再將每個縣市依照人口密度與家戶可支配所得區分為不同社經等級，同樣探討不同年代不平等趨勢。不平等測
量包括絕對（死亡率差與變異係數）與相對（死亡率比）不平等。
結果：由2008 年到2019 年年齡標準化死亡率年下降百分比，總死因是0.9%，可避免死因是1.8%，非可避免死因是0.3%，公衛可預防死因是2.1%，醫療可治療死因是1.6%。女性的下降程度大於男性，以可避免死因為例，女性是2.2%，男性是1.6%。縣市地區絕對不平等，死亡率變異係數的年代改變可以看到可避免死因沒有改變，非可避免死因反而縮小，2017-2019/2008-2010 分別是1.01 與0.85。醫療可治療死因的變異係數縮小，公衛可預防死因的變異係數增加，2017-2019/2008-2010 分別是0.88 與1.09。相對不平等也出現類似的年代改變，最高最低死亡率比的縮小程度，非可避免死因大於可避免死因，2017-2019/2008-2010 分別是0.86 與1.01。醫療可治療死因大於公衛可預防死因，2017-2019/2008-2010 分別0.76 與1.04。至於縣市社經不平等的趨勢，使用家戶可支配所得為社經指標不平等趨勢增加。使用都市化程度為社經指標不平等趨勢不變或稍微縮小。死因別差異沒有很一致與明顯趨勢。
結論：本研究結果顯示台灣整體而言可避免死因死亡率下降趨勢大於非可避免死因，公衛可預防死因大於醫療可預防死因。縣市地區不平等也是出現不平等縮小趨勢，但是非可避免死因縮小程度大於可避免死因。關於非可避免死因地區不平等縮小程度大於可避免死因的非預期發現，還有待進一步分析特定死因別死亡率來回答。

This study aimed to examine the city/county inequality in avoidable mortality (AM) in Taiwan from 2008 through 2019. We obtained the city/county cause of death mortality data from the open datasets released by the Ministry of Health and Welfare. The definitions of AM was according to the OECD/Eurostat 2019 version. Population density and household disposable income in each city/county were used to classify four level of socioeconomic status. Annual percent changes (APCs) derived from joinpoint regression model were used to assess the secular trends of different causes of death in Taiwan. Absolute (rate differences and coefficient of variation [CV]) and relative (rate ratios) inequality measures were calculated were calculated to examine the city/county inequality. The APC for all causes, AM, non-AV, public health preventable (PHP), and medical care treatable (MCT) mortality from 2008 to 2019 was -0.9%, -1.8%, -0.3%, -2.1%, and -1.6%, respectively. Women had larger exlent in decline of AM than men, the APC of AM was -2.2% and -1.6%, respectively. With regard to the absolute regional inequality, the CV ratio between 2017-2019 with 2008-2010 was 1.01 and 0.85, respectively for AM and non-AM. Similarly, the relative regional inequality (highest and lowest mortality ratio) showed larger decline for non-AM than AM, the 2017-2019/2008-2010 ratio was 0.86 and 1.01, respectively. The 2017-2019/2008-2010 ratio for MCT and PHP was 0.76 and 1.04, respectively. Regarding the trends in socioeconomic inequality, the inequality according to household income increased; on the contrary, the inequality
according to urbanization level was decreasing or stable. No consistent relationships were found for different causes. In conclusion, further studies on specific causes of death are needed to explain why the non-AM had larger extent of decline in regional equality than AM in Taiwan.

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