Assessing Quantitative Comparisons of Health and Social Care Between Countries

Carlson, Marjorie; Roy, Brita; Groenewoud, A. Stef

doi:10.1001/jama.2020.3813

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…As in other disease areas, our study adds to the literature suggesting superior health outcomes in higher income countries (and likely better health systems and treatment access). (3,10,27) Only a very small part of the effect of these country level socioeconomic factors can be explained by inequities in the b/tsDMARDs uptake, meaning that differences may be caused not only by the lack of access to more effective though expensive treatments, but also by lower access to rheumatologists, differences in knowledge and medical decision making, medical and patient beliefs, preferences and cultural background. (28) Our study indicates the effect of gender on disease activity (although with differences in magnitude) was not different among countries but seems universal.…”

Section: Discussionmentioning

confidence: 99%

Individual-level and country-level socio-economic factors and health outcomes in spondyloarthritis: analysis of the ASAS-perSpA study

et al. 2021

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Objectives To investigate the association between individual and country-level socioeconomic (SE) factors and health outcomes across spondyloarthritis (SpA) phenotypes. Methods Patients with axial SpA, peripheral SpA or psoriatic arthritis (PsA) from the ASAS-perSpA study (23 countries) were included. The effect of individual (age, gender, education and marital status) and country-level (e.g. Gross Domestic Product [GDP]) SE factors on health outcomes (ASDAS ≥ 2.1, ASDAS, BASFI, fatigue and ASAS-HI) was assessed in mixed-effects models, adjusted for potential confounders. Interactions between SE factors and disease phenotype were tested. A mediation analysis was conducted to explore whether the impact of country-level SE factors on ASDAS was mediated through b/tsDMARD uptake. Results In total 4185 patients (61% males, mean age 45) were included (65% axSpA, 25% PsA, 10% pSpA). Female gender (β = 0.14 (95%CI 0.06–0.23)) lower educational level (0.35 (0.25–0.45)) and single marital status (0.09 (0.01–0.17)) were associated with higher ASDAS. Living in lower GDP countries was also associated with higher ASDAS (0.39 (0.16–0.63)) and 7% of this association was mediated by b/tsDMARD uptake. Higher BASFI was similarly associated with female gender, lower education and living alone, without effect of country-level SE factors. Female gender and lower educational level were associated with worse ASAS-HI, while more fatigue was associated with female gender and higher country-level SE factors (lower GDP, -0.46 (-0.89 to -0.04)). No differences across disease phenotype were found. Conclusions Our study shows country-driven variations in health outcomes in SpA, independently influenced by individual and country-level SE factors and without differences across disease phenotypes.

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Section: Discussionmentioning

confidence: 99%

Individual-level and country-level socio-economic factors and health outcomes in spondyloarthritis: analysis of the ASAS-perSpA study

et al. 2021

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“…International comparisons of health and social care is a compelling evaluation of quantitative comparisons of cross-national health and social care indicators with individual-level data by Carlson, Roy and Groenewoud (2020). The discussion is highly informative in terms of the quality of care, its effectiveness in terms of health and medical outcomes, and associated costs that are not independent of the quality of health, medical and social care that are dispensed.…”

Section: Discussionmentioning

confidence: 99%

Comments on Recent COVID-19 Research in JAMA

2020

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The SARS-CoV-2 that causes the COVID-19 disease is a one-in-a-century disaster that has led to profound structural change in every conceivable aspect of the worldwide community. The COVID-19 pandemic is the most topical subject in the academic community across all disciplines, but especially in the medical and biomedical research disciplines, where attempts to discover a safe, effective, timely, inexpensive, and accessible vaccine is at the top of everyone's wish list. There is a substantial amount of confusion, ambiguity, and misinformation in the academic community, and far more so in social mass media. Leading medical journals, such as the Journal of the American Medical Association (JAMA), The Lancet, and the New England Journal of Medicine, have published informative case studies that seek to provide guidance on COVID-19 at the earliest possible opportunity.

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Early repeat hospitalization for fluid overload in individuals with cardiovascular disease and risks: a retrospective cohort study

Lim,

Huang,

Huang

et al. 2023

Int Urol Nephrol

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Assessing Quantitative Comparisons of Health and Social Care Between Countries

Abstract: This Viewpoint discusses differences that complicate cross-country comparisons of health and social services and proposes a framework for assessing the appropriateness of those comparisons to help researchers improve their investigations and help readers critically appraise them.

Cited by 4 publications

References 10 publications

Individual-level and country-level socio-economic factors and health outcomes in spondyloarthritis: analysis of the ASAS-perSpA study

Individual-level and country-level socio-economic factors and health outcomes in spondyloarthritis: analysis of the ASAS-perSpA study

Comments on Recent COVID-19 Research in JAMA

Early repeat hospitalization for fluid overload in individuals with cardiovascular disease and risks: a retrospective cohort study

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