Faculty of Medicine, University of Western São Paulo (UNOESTE), Presidente Prudente, Sao Paulo, Brazil; Physical Therapy Department, Faculty of Science and Technology, Sao Paulo State University, Presidente Prudente, Brazil; Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia.
Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Public Health. 2023 Sep;222:66-74. doi: 10.1016/j.puhe.2023.06.038. Epub 2023 Jul 29.
To investigate the alignment of national health priorities with a country's burden of disease as measured by disability-adjusted life years (DALYs).
We identified priorities in national health plans and the 20 most burdensome conditions measured by DALYs from the 2017 Global Burden of Disease Study. We computed point-biserial correlations (rpb) between DALYs and being nominated as a health priority and the pooled proportion (95% confidence intervals [CIs]) of the 20 most burdensome conditions nominated as a priority across countries.
We identified national health plans and official governmental websites in 145 countries. There was little to no correlation (rpb = 0.06, 95% CI: 0.02 to 0.09) between national DALY data and whether a condition was nominated as a health priority. The pooled proportion of the 20 most burdensome conditions nominated as priorities across countries was 46%. HIV/AIDS had the greatest number of nominations as a national health priority (62 countries) as well as the greatest match with the burden of disease (among the top 20 most burdensome conditions in 51 [82%] countries). Low back pain, headache disorders and congenital birth defects had the lowest proportion of nominations as health priorities in countries where they were in the top 20 most burdensome conditions (6%, 6% and 11%, respectively).
Globally, there were low correlations between national health priorities and GBD estimates on disease burden. Failing to prioritise health priorities according to burden may mean that insufficient resources have been directed to improve health outcomes for people with those health conditions.
调查国家卫生重点与疾病负担（以伤残调整生命年衡量）的一致性。
我们确定了国家卫生计划中的重点和 2017 年全球疾病负担研究中以伤残调整生命年衡量的 20 种最具负担的疾病。我们计算了伤残调整生命年与被提名作为卫生重点之间的点二列相关系数（rpb），以及各国提名作为优先事项的 20 种最具负担的疾病中被提名作为优先事项的比例（95%置信区间[CI]）。
我们在 145 个国家确定了国家卫生计划和官方政府网站。国家伤残调整生命年数据与疾病是否被提名作为卫生重点之间几乎没有相关性（rpb=0.06，95%CI：0.02 至 0.09）。在各国中，被提名作为优先事项的 20 种最具负担疾病的比例为 46%。艾滋病毒/艾滋病作为国家卫生重点被提名的次数最多（62 个国家），与疾病负担的匹配度最高（在 51 个（82%）国家中，在前 20 种最具负担的疾病中）。在这些国家中，背痛、头痛障碍和先天性出生缺陷被提名作为卫生重点的比例最低（分别为 6%、6%和 11%）。
全球范围内，国家卫生重点与全球疾病负担估计之间的相关性较低。未能根据负担情况确定卫生重点可能意味着为改善这些卫生状况人群的健康结果而投入的资源不足。
