Quality of Care of Peptic Ulcer Disease Worldwide: A Systematic Analysis for the Global Burden of Disease Study 1990-2019 Publisher Pubmed



Abbasikangevari M¹ ; Ahmadi N¹ ; Fattahi N¹ ; Rezaei N^{1, 2} ; Malekpour MR¹ ; Ghamari SH¹ ; Moghaddam SS¹ ; Azadnajafabad S¹ ; Esfahani Z^{1, 3} ; Kolahi AA⁴ ; Roshani S^{1, 5} ; Rezazadehkhadem S¹ ; Gorgani F¹ ; Naleini SN⁶ Show All Authors Show Affiliations
Source: PLoS ONE Published:2022

Abstract

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-lifelost-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-Asiapacific 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. Copyright: © 2022 Abbasi-Kangevari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.