Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Lancet. 2021 Dec 19;396(10267):2006-2017. doi: 10.1016/S0140-6736(20)32340-0. Epub 2020 Dec 1.
Rehabilitation has often been seen as a disability-specific service needed by only few of the population. Despite its individual and societal benefits, rehabilitation has not been prioritised in countries and is under-resourced. We present global, regional, and country data for the number of people who would benefit from rehabilitation at least once during the course of their disabling illness or injury.
To estimate the need for rehabilitation, data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were used to calculate the prevalence and years of life lived with disability (YLDs) of 25 diseases, impairments, or bespoke aggregations of sequelae that were selected as amenable to rehabilitation. All analyses were done at the country level and then aggregated to seven regions: World Bank high-income countries and the six WHO regions (ie, Africa, the Americas, Southeast Asia, Europe, Eastern Mediterranean, and Western Pacific).
Globally, in 2019, 2·41 billion (95% uncertainty interval 2·34-2·50) individuals had conditions that would benefit from rehabilitation, contributing to 310 million [235-392] YLDs. This number had increased by 63% from 1990 to 2019. Regionally, the Western Pacific had the highest need of rehabilitation services (610 million people [588-636] and 83 million YLDs [62-106]). The disease area that contributed most to prevalence was musculoskeletal disorders (1·71 billion people [1·68-1·80]), with low back pain being the most prevalent condition in 134 of the 204 countries analysed.
To our knowledge, this is the first study to produce a global estimate of the need for rehabilitation services and to show that at least one in every three people in the world needs rehabilitation at some point in the course of their illness or injury. This number counters the common view of rehabilitation as a service required by only few people. We argue that rehabilitation needs to be brought close to communities as an integral part of primary health care to reach more people in need.
Bill & Melinda Gates Foundation.
康复常常被视为一种仅少数人群需要的特定于残疾的服务。尽管康复具有个体和社会效益，但它并未在各国得到优先重视，资源也不足。我们提供了全球、区域和国家层面的数据，这些数据表明，在残疾性疾病或损伤的病程中，至少有一部分人需要接受康复治疗。
为了估算康复需求，我们使用 2019 年全球疾病、伤害和危险因素研究的数据，计算了 25 种疾病、损伤或可通过康复治疗的后遗症的特定组合的患病率和残疾生存年数（YLDs）。所有分析均在国家层面进行，然后汇总到七个区域：世界银行高收入国家和世卫组织的六个区域（即非洲、美洲、东南亚、欧洲、东地中海和西太平洋）。
2019 年，全球有 24.1 亿人（95%置信区间为 23.4-25.0）患有需要康复治疗的疾病，导致 3.1 亿残疾生存年数（2.35-2.92）。这一数字与 1990 年相比增加了 63%。在区域层面上，西太平洋地区对康复服务的需求最高（6.1 亿人[5.88-6.36]和 8300 万残疾生存年数[62-106]）。对患病率贡献最大的疾病领域是肌肉骨骼疾病（17.1 亿人[1.68-1.80]），在分析的 204 个国家中，134 个国家都有腰痛这种最常见的疾病。
据我们所知，这是第一项对全球康复服务需求进行估算的研究，并表明，世界上至少每三人在其疾病或损伤的病程中就有一人需要康复治疗。这一数字反驳了康复服务只需要少数人提供的常见观点。我们认为，需要将康复作为初级卫生保健的一个组成部分，在社区中提供，以惠及更多有需要的人。
比尔及梅琳达·盖茨基金会。
