Global and regional burden and quality of care of non-rheumatic valvular heart diseases: a systematic analysis of Global Burden of Disease 1990–2017

Abstract

Background With increase in incidence and prevalence of non-rheumatic valvular heart diseases (NRVHDs), having a proper understanding of the disease current status in terms of quality of care and healthcare access can considerably affect further planning for the healthcare system. In this study we aimed to evaluate and compare the quality and equity of care concerning NRVHDs in terms of gender and sociodemographic index (SDI) using a newly proposed index. Methods We obtained the primary measures (e.g., incidence) from the Global Burden of Disease (GBD) data about NRVHD from 1990 to 2017 to calculate the subsequent secondary indices (e.g., mortality-to-incidence ratio) with close association to quality of care. Then, using principal component analysis (PCA), quality of care index (QCI) was calculated as a novel index from the secondary indices, rescaled to 0-100. QCI was calculated for all age-groups and both genders, globally, regionally, and nationally between 1990–2017. Results Globally, the QCI for NRVHDs in 2017 was 87.3, and it appears that gender inequity was unremarkable (gender disparity ratio=1.00, female QCI: 90.2, male QCI: 89.7) in 2017 similar to the past three decades. Among WHO world regions, the Western-Pacific Region and Eastern-Mediterranean Region showed the highest (90.1) and lowest (74.0) QCI scores. Regarding SDI, the high-middle-SDI quintile with a QCI of 89.4 and low-SDI quintile with a QCI of 77.8 were the two extremes of healthcare quality in 2017. Conclusion Although global status regarding the NRVHD’s quality of care is acceptable, higher attention is required for lower SDI countries.

Quality of care of peptic ulcer disease worldwide: A systematic analysis for the global burden of disease study 1990–2019

“…The advantage of QCI is that, unlike HAQ Index, it could be used to present inequities among both sexes, age groups, and in all the seven GBD super-regions and 21 regions. QCI combined mortality to incidence ratio [ 44 ], DALYs to prevalence ratio [ 45 ], prevalence to incidence ratio [ 46 ], and YLLs to YLDs ratio [ 47 ], into a single index, aiming to demonstrate the quality of care among countries [ 9 – 11 , 28 , 47 – 49 ]. Although QCI does not reflect all the aspects of the quality of services among healthcare systems, it could be used as a proxy for comparing various countries.…”

Thirty-Year Trend of Non-Rheumatic Valvular Heart Disease: A Comparison of Pakistan With South Asia and Global Scenario

“…Such an increase can be attributed to a trend toward an aging population and a general increase in life expectancy. 16 The socioeconomic growth and quality of healthcare infrastructure dramatically vary among the various administrative territories of the country. 17 Similarly, varying trends in the burden of non-rheumatic VHD have been witnessed for the different administrative territories of the country.…”

“…18,24 Hence, it is essential to understand the underlying genetic, pathophysiological, and anatomic mechanisms behind the development of non-rheumatic VHD so the preventive and management option can be tailored to the task. 16 In addition to the various other methodological limitations of the GBD estimation process described previously, 25 the lack of reliable national representative studies of the data for Pakistan to use for the computation of reliable national representative estimates is the main limitation in the first place.…”

Expansion of the quality of care index on breast cancer and its risk factors using the global burden of disease study 2019

“…Calculation details and codes of QCI are available in a published protocol 26 . Also, other published articles utilizing the QCI to evaluate quality of care are available to prove the efficacy of this proxy 27‐38 . In summary, QCI is generated from the integration of four indices of mortality to incidence ratio (MIR), DALYs to prevalence ratio, prevalence to incidence ratio, and YLLs to YLDs ratio compiled by the principal component analysis (PCA) method 39 .…”