全球消化性溃疡病的医疗质量：全球疾病负担研究 1990-2019 年的系统分析。
Quality of care of peptic ulcer disease worldwide: A systematic analysis for the global burden of disease study 1990-2019.
机构信息
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
PLoS One. 2022 Aug 1;17(8):e0271284. doi: 10.1371/journal.pone.0271284. eCollection 2022.
BACKGROUND
Peptic ulcer disease (PUD) affects four million people worldwide annually and has an estimated lifetime prevalence of 5-10% in the general population. Worldwide, there are significant heterogeneities in coping approaches of healthcare systems with PUD in prevention, diagnosis, treatment, and follow-up. Quantifying and benchmarking health systems' performance is crucial yet challenging to provide a clearer picture of the potential global inequities in the quality of care.
OBJECTIVE
The objective of this study was to compare the health-system quality-of-care and inequities for PUD among age groups and sexes worldwide.
METHODS
Data were derived from the Global Burden of Disease Study 1990-2019. Principal-Component-Analysis was used to combine age-standardized mortality-to-incidence-ratio, disability-adjusted-life-years-to-prevalence-ratio, prevalence-to-incidence-ratio, and years-of-life-lost-to-years-lived-with-disability-into a single proxy named Quality-of-Care-Index (QCI). QCI was used to compare the quality of care among countries. QCI's validity was investigated via correlation with the cause-specific Healthcare-Access-and-Quality-index, which was acceptable. Inequities were presented among age groups and sexes. Gender Disparity Ratio was obtained by dividing the score of women by that of men.
RESULTS
Global QCI was 72.6 in 1990, which increased by 14.6% to 83.2 in 2019. High-income-Asia-pacific had the highest QCI, while Central Latin America had the lowest. QCI of high-SDI countries was 82.9 in 1990, which increased to 92.9 in 2019. The QCI of low-SDI countries was 65.0 in 1990, which increased to 76.9 in 2019. There was heterogeneity among the QCI-level of countries with the same SDI level. QCI typically decreased as people aged; however, this gap was more significant among low-SDI countries. The global Gender Disparity Ratio was close to one and ranged from 0.97 to 1.03 in 100 of 204 countries.
CONCLUSION
QCI of PUD improved dramatically during 1990-2019 worldwide. There are still significant heterogeneities among countries on different and similar SDI levels.
背景
消化性溃疡病（PUD）影响全球每年 400 万人，其在普通人群中的终生患病率估计为 5-10%。在全球范围内，在预防、诊断、治疗和随访方面，医疗保健系统应对 PUD 的方法存在显著差异。量化和基准化卫生系统的绩效对于更清楚地了解护理质量方面潜在的全球不平等至关重要，但也具有挑战性。
目的
本研究旨在比较全球各年龄段和性别人群的 PUD 卫生系统保健质量和差异。
方法
数据来自 1990-2019 年全球疾病负担研究。主成分分析用于将年龄标准化死亡率与发病率比、残疾调整生命年与患病率比、患病率与发病率比以及生命年损失与残疾生存年数结合到一个名为保健质量指数（QCI）的单一指标中。QCI 用于比较各国之间的保健质量。通过与可接受的特定病因保健获取和质量指数相关联来检验 QCI 的有效性。在不同年龄组和性别之间呈现差异。通过将女性的得分除以男性的得分来获得性别差异比。
结果
1990 年全球 QCI 为 72.6，2019 年增长 14.6%至 83.2。高收入亚太地区的 QCI 最高，而中拉丁美洲的 QCI 最低。1990 年高 SD 国家的 QCI 为 82.9，2019 年增加到 92.9。1990 年低 SD 国家的 QCI 为 65.0，2019 年增加到 76.9。具有相同 SD 水平的国家之间 QCI 水平存在差异。QCI 通常随着年龄的增长而降低；然而，在低 SD 国家，这种差距更为显著。全球性别差异比接近 1，在 204 个国家中的 100 个国家中范围在 0.97 到 1.03 之间。
结论
1990-2019 年期间，全球范围内 PUD 的 QCI 显著提高。在不同和相似 SD 水平的国家之间仍然存在显著的差异。
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