The global burden of adverse effects of medical treatment: a 30-year socio-demographic and geographic analysis using GBD 2021 data.

IF 2.4 Q3 COMPUTER SCIENCE, INFORMATION SYSTEMS

Frontiers in Big Data Pub Date : 2025-08-01 eCollection Date: 2025-01-01 DOI:10.3389/fdata.2025.1590551

Hanxin Lu, Xinyan Cheng, Jun Xiong

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Abstract

Background: Adverse effects of medical treatment (AEMT) pose critical global health challenges, yet comprehensive analyses of their long-term burden across socio-demographic contexts remain limited. This study evaluates 30-year trends (1990-2021) in AEMT-related mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) across 204 countries using Global Burden of Disease (GBD) 2021 data.

Methods: Age-standardized rates (ASRs) were stratified by sociodemographic index (SDI) quintiles. Frontier efficiency analysis quantified health loss boundaries relative to SDI, while concentration (C) and slope indices of inequality (SII) assessed health inequities. Predictive models projected trends to 2035.

Results: Global age-standardized mortality rates (ASDR) declined by 36.3%, with low-SDI countries achieving the steepest reductions (5.31 to 3.71/100,000) but remaining 3.9-fold higher than high-SDI nations. DALYs decreased by 39.7% (106.49 to 64.19/100,000), driven by infectious disease control in low-SDI regions. High-SDI countries experienced post-2010 mortality rebounds (0.86 to 0.95/100,000), linked to aging and complex interventions. YLLs declined by 40.3% (104.87 to 62.66/100,000), while YLDs peaked transiently (2010: 1.95/100,000). Frontier analysis revealed low-SDI countries lagged furthest from optimal health outcomes, and inequality indices highlighted entrenched disparities (C: -0.34 for premature mortality). Projections suggest continued declines in ASDR, DALYs, and YLLs by 2035, contingent on addressing antimicrobial resistance and surgical overuse.

Conclusions: SDI-driven inequities necessitate tailored interventions: low-SDI regions require strengthened infection control and primary care, while high-SDI systems must mitigate overmedicalization risks. Hybrid strategies integrating digital health and cross-sector collaboration are critical for equitable burden reduction.

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医疗不良影响的全球负担：使用GBD 2021数据的30年社会人口和地理分析

背景：医疗不良反应（AEMT）构成了严重的全球健康挑战，但在社会人口背景下对其长期负担的全面分析仍然有限。本研究使用全球疾病负担（GBD） 2021数据评估了204个国家aemt相关死亡率、残疾调整生命年（DALYs）、残疾生存年（YLDs）和生命损失年（YLLs）的30年趋势（1990-2021）。方法：采用社会人口指数（SDI）五分位数对年龄标准化率（ASRs）进行分层。前沿效率分析量化了与SDI相关的健康损失边界，而不平等的浓度(C)和斜率指数（SII）评估了健康不平等。预测模型预测了2035年的趋势。结果：全球年龄标准化死亡率（ASDR）下降了36.3%，低sdi国家降幅最大（5.31 /10万至3.71/10万），但仍比高sdi国家高3.9倍。受低sdi地区传染病控制的影响，DALYs下降了39.7%（106.49 ~ 64.19/10万）。高sdi国家的死亡率在2010年后出现反弹（0.86至0.95/10万），这与老龄化和复杂的干预措施有关。yll下降了40.3%（104.87至62.66/10万），而yld短暂达到峰值（2010年为1.95/10万）。前沿分析显示，低sdi国家与最佳健康结果差距最大，不平等指数突出了根深蒂固的差距（过早死亡率C: -0.34）。预测显示，到2035年，ASDR、DALYs和YLLs将继续下降，这取决于解决抗菌素耐药性和手术过度使用问题。结论：sdi驱动的不平等需要量身定制的干预措施：低sdi地区需要加强感染控制和初级保健，而高sdi系统必须减轻过度医疗化风险。综合数字卫生和跨部门协作的混合战略对于公平减轻负担至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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