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按病种划分的物理康复需求:来自 2017 年全球疾病负担研究的结果。

Physical Rehabilitation Needs Per Condition Type: Results From the Global Burden of Disease Study 2017.

机构信息

Global Health and Tropical Medicine and WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon, Lisbon, Portugal.

School of Medicine, Duke University, Durham, NC; Duke Global Health Institute, Duke University, Durham, NC.

出版信息

Arch Phys Med Rehabil. 2020 Jun;101(6):960-968. doi: 10.1016/j.apmr.2019.12.020. Epub 2020 Feb 5.

Abstract

OBJECTIVE

To determine how total physical rehabilitation needs have been distributed per relevant condition groups (musculoskeletal and pain, neurologic cardiothoracic, neoplasms, pediatric, human immunodeficiency virus [HIV] related), globally and across countries of varying income level.

DESIGN

Subgroup, secondary analyses of data from the Global Burden of Disease 2017. Data for the year 2017 are used for determining current needs and data from every year between 1990 and 2017 for determining changing trends.

SETTINGS

Globally and high-, upper-middle-, lower-middle-, and low-income countries.

PARTICIPANTS

Not applicable.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

Years lived with disability (YLD) rates per 100,000 people for the 6 condition groups.

RESULTS

In 2017, musculoskeletal and pain conditions accounted for 52.6% of the total physical rehabilitation needs worldwide, :HIV related for 5.7% of the physical rehabilitation needs in low-income nations, but about 1% in all other locations. Worldwide, significant increases in YLD rates were observed since 1990 for the 6 condition groups (P<.01). However, across country types, we observed significant decreases in YLD rates for specific conditions: pediatric in high-income countries, and neurologic and neoplasm conditions in low-income countries (P<.01). In upper-middle-income countries, YLD rates from neurologic and neoplasm conditions grew exponentially since 1990, with overall increases of 67% and 130%, respectively.

CONCLUSION

At a global scale, physical rehabilitation needs per capita are growing for all major condition groups, with musculoskeletal and pain conditions currently accounting for over half of those needs. Countries of varying income level have different typologies and evolutionary trends in their rehabilitation needs.

摘要

目的

确定全球范围内以及不同收入水平国家中,各相关疾病组别(肌肉骨骼和疼痛、神经、心肺、肿瘤、儿科、艾滋病毒[HIV]相关)的总体身体康复需求是如何分布的。

设计

对全球疾病负担 2017 年数据的子群、二次分析。2017 年的数据用于确定当前需求,而 1990 年至 2017 年的每年数据用于确定变化趋势。

地点

全球范围以及高收入、上中等收入、中下等收入和低收入国家。

参与者

不适用。

干预措施

不适用。

主要观察指标

6 个疾病组每 10 万人的残疾生活年(YLD)率。

结果

2017 年,肌肉骨骼和疼痛疾病占全球身体康复总需求的 52.6%,HIV 相关疾病占低收入国家身体康复需求的 5.7%,而在其他所有地区则约占 1%。自 1990 年以来,全球范围内 6 个疾病组的 YLD 率显著增加(P<.01)。然而,在不同国家类型中,我们观察到特定疾病的 YLD 率显著下降:高收入国家的儿科疾病,以及低收入国家的神经和肿瘤疾病(P<.01)。在上中等收入国家,自 1990 年以来,神经和肿瘤疾病的 YLD 率呈指数增长,分别增长了 67%和 130%。

结论

在全球范围内,所有主要疾病组别的人均身体康复需求都在增长,肌肉骨骼和疼痛疾病目前占这些需求的一半以上。不同收入水平的国家在康复需求方面存在不同的类型和演变趋势。

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