Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
PLoS One. 2021 Feb 22;16(2):e0247120. doi: 10.1371/journal.pone.0247120. eCollection 2021.
Primary brain and other central nervous system (CNS) cancers cause major burdens. In this study, we introduced a measure named the Quality of Care Index (QCI), which indirectly evaluates the quality of care given to patients with this group of cancers. Here we aimed to compare different geographic and socioeconomic patterns of CNS cancer care according to the novel measure introduced. In this regard, we acquired age-standardized primary epidemiologic measures were acquired from the Global Burden of Disease (GBD) study 1990-2017. The primary measures were combined to make four secondary indices which all of them indirectly show the quality of care given to patients. Principal Component Analysis (PCA) method was utilized to calculate the essential component named QCI. Further analyses were made based on QCI to assess the quality of care globally, regionally, and nationally (with a scale of 0-100 which higher values represent better quality of care). For 2017, the global calculated QCI was 55.0. QCI showed a desirable condition in higher socio-demographic index (SDI) quintiles. Oppositely, low SDI quintile countries (7.7) had critically worse care quality. Western Pacific Region with the highest (76.9) and African Region with the lowest QCIs (9.9) were the two WHO regions extremes. Singapore was the country with the maximum QCI of 100, followed by Japan (99.9) and South Korea (98.9). In contrast, Swaziland (2.5), Lesotho (3.5), and Vanuatu (3.9) were countries with the worse condition. While the quality of care for most regions was desirable, regions with economic constraints showed to have poor quality of care and require enforcements toward this lethal diagnosis.
原发性脑癌和其他中枢神经系统（CNS）癌症造成了重大负担。在这项研究中，我们引入了一种名为“护理质量指数（QCI）”的衡量标准，它可以间接评估对这组癌症患者的护理质量。在这里，我们旨在根据引入的新措施，比较中枢神经系统癌症护理的不同地理和社会经济模式。为此，我们从全球疾病负担（GBD）研究 1990-2017 年获得了标准化年龄的主要流行病学指标。这些主要指标被组合成四个次要指标，它们都间接地反映了患者接受的护理质量。我们利用主成分分析（PCA）方法计算了一个名为 QCI 的基本组成部分。然后，我们基于 QCI 进行了进一步分析，以评估全球、区域和国家的护理质量（分值范围为 0-100，分值越高代表护理质量越好）。2017 年，全球计算得出的 QCI 为 55.0。QCI 在较高社会人口指数（SDI）五分位数中表现出良好的状态。相反，SDI 五分位数较低的国家（7.7）的护理质量则非常差。在世界卫生组织（WHO）的两个区域中，西太平洋地区（76.9）的 QCI 最高，而非洲地区（9.9）的 QCI 最低。新加坡是 QCI 最高的国家，为 100，其次是日本（99.9）和韩国（98.9）。相比之下，斯威士兰（2.5）、莱索托（3.5）和瓦努阿图（3.9）的情况最差。虽然大多数地区的护理质量都很好，但经济受限的地区的护理质量较差，需要加强对这种致命诊断的护理。
