Mody Kush S, Henstenburg Jeffrey, Herman Martin J
Columbia Business School, New York, NY, USA.
Drexel University College of Medicine, Philadelphia, PA, USA.
Glob Pediatr Health. 2021 Feb 25;8:2333794X21994998. doi: 10.1177/2333794X21994998. eCollection 2021.
Large disparities exist in congenital musculoskeletal disease burden worldwide. The purpose of this study is to examine and quantify the health and economic disparities of congenital musculoskeletal disease by country income level from 1992 to 2017. : The Global Burden of Disease database was queried for information on disease burden attributed to "congenital musculoskeletal and limb anomalies" from 1992 to 2017. Gross national income per capita was extracted from the World Bank website. Nonparametric Kruskal-Wallis tests were used to compare morbidity and mortality across years and income levels. The number of avertable DALYs was converted to an economic disparity using the human-capital and value of a statistical life approach. : From 1992 to 2017, a significant decrease in deaths/100 000 was observed only in upper-middle and high income countries. Northern Africa, the Middle East, and Eastern Europe were disproportionately affected. If the burden of disease in low- and middle- income countries (LMICs) was equivalent to that in high income countries (HICs), 10% of all DALYs and 70% of all deaths attributable to congenital musculoskeletal disease in LMICs could be averted. This equates to an economic disparity of about $2 billion to $3 billion (in 2020 $USD). : Considerable inequity exists in the burden of congenital musculoskeletal disease worldwide and there has been no change over the last 25 years in total disease burden and geographical distribution. By reducing the disease burden in LMICs to rates found in HICs, a large proportion of the health and economic consequences could be averted.
全球先天性肌肉骨骼疾病负担存在巨大差异。本研究的目的是按国家收入水平审视和量化1992年至2017年先天性肌肉骨骼疾病的健康和经济差异。：查询全球疾病负担数据库，获取1992年至2017年归因于“先天性肌肉骨骼和肢体异常”的疾病负担信息。人均国民总收入从世界银行网站提取。使用非参数Kruskal-Wallis检验比较各年份和收入水平的发病率和死亡率。采用人力资本法和统计生命价值法将可避免的伤残调整生命年数转化为经济差异。：1992年至2017年，仅在中高收入国家和高收入国家观察到每10万人死亡人数显著下降。北非、中东和东欧受到的影响尤为严重。如果低收入和中等收入国家（LMICs）的疾病负担与高收入国家（HICs）相当，那么低收入和中等收入国家中可避免10%的先天性肌肉骨骼疾病所致伤残调整生命年数和70%的死亡人数。这相当于约20亿至30亿美元的经济差异（以2020年美元计）。：全球先天性肌肉骨骼疾病负担存在相当大的不公平性，过去25年疾病总负担和地理分布没有变化。通过将低收入和中等收入国家的疾病负担降至高收入国家的水平，可以避免很大一部分健康和经济后果。
