Global, regional and national time trends in incidence of adverse effects of medical treatment, 1990-2019: an age-period-cohort analysis from the Global Burden of Disease 2019 study.

IF 5.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Liangquan Lin
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引用次数: 0

Abstract

Background: Current adverse effects of medical treatment (AEMT) incidence estimates rely on limited record reviews and underreporting surveillance systems. This study evaluated global and national longitudinal patterns in AEMT incidence from 1990 to 2019 using the Global Burden of Disease (GBD) framework.

Methods: AEMT was defined as harm resulting from a procedure, treatment or other contact with the healthcare system. The overall crude incidence rate, age-standardised incidence rate and their changes over time were analysed to evaluate temporal trends. Data were stratified by sociodemographic index (SDI) quintiles, age groups and sex to address heterogeneity across and within nations. An age-period-cohort model framework was used to differentiate the contributions of age, period and cohort effects on AEMT incidence changes. The model estimated overall and age-specific annual percentage changes in incidence rates.

Findings: Although the global population increased 44.6% from 1990 to 2019, AEMT incidents rose faster by 59.3%. The net drift in the global incidence rate was 0.631% per year. The proportion of all cases accounted for by older adults and the incidence rate among older adults increased globally. The high SDI region had much higher and increasing incidence rates versus declining rates in lower SDI regions. The age effects showed that in the high SDI region, the incidence rate is higher among older adults. Globally, the period effect showed a rising incidence of risk after 2002. Lower SDI regions exhibited a significant increase in incidence risk after 2012. Globally, the cohort effect showed a continually increasing incidence risk across sequential birth cohorts from 1900 to 1950.

Conclusion: As the global population ageing intensifies alongside the increasing quantity of healthcare services provided, measures need to be taken to address the continuously rising burden of AEMT among the older population.

1990-2019 年全球、地区和国家医疗不良反应发生率的时间趋势:2019 年全球疾病负担研究的年龄段队列分析。
背景:目前的医疗不良反应(AEMT)发病率估计依赖于有限的记录审查和漏报监测系统。本研究采用全球疾病负担(GBD)框架,评估了1990年至2019年全球和各国AEMT发生率的纵向模式:AEMT被定义为因手术、治疗或与医疗系统的其他接触而造成的伤害。分析了总体粗发病率、年龄标准化发病率及其随时间的变化,以评估时间趋势。数据按社会人口指数(SDI)五分位数、年龄组和性别进行分层,以解决国家间和国家内的异质性问题。采用年龄-时期-队列模型框架来区分年龄、时期和队列效应对 AEMT 发病率变化的影响。该模型估计了发病率的总体和特定年龄的年度百分比变化:尽管从 1990 年到 2019 年全球人口增长了 44.6%,但 AEMT 发病率却增长了 59.3%。全球发病率每年净漂移 0.631%。在全球范围内,老年人占所有病例的比例和老年人的发病率都有所上升。高 SDI 地区的发病率更高且呈上升趋势,而低 SDI 地区的发病率则呈下降趋势。年龄效应显示,在 SDI 高的地区,老年人的发病率更高。从全球来看,时期效应显示 2002 年后风险发生率上升。SDI 较低地区的发病风险在 2012 年后显著增加。从全球来看,队列效应显示,从 1900 年到 1950 年,连续出生队列的发病风险持续上升:随着全球人口老龄化的加剧以及医疗保健服务数量的增加,需要采取措施解决老年人口中不断增加的急性心肌梗死负担。
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来源期刊
BMJ Quality & Safety
BMJ Quality & Safety HEALTH CARE SCIENCES & SERVICES-
CiteScore
9.80
自引率
7.40%
发文量
104
审稿时长
4-8 weeks
期刊介绍: BMJ Quality & Safety (previously Quality & Safety in Health Care) is an international peer review publication providing research, opinions, debates and reviews for academics, clinicians and healthcare managers focused on the quality and safety of health care and the science of improvement. The journal receives approximately 1000 manuscripts a year and has an acceptance rate for original research of 12%. Time from submission to first decision averages 22 days and accepted articles are typically published online within 20 days. Its current impact factor is 3.281.
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