Global Burden of Disease Due to Ambulatory Care Sensitive Conditions, 1990-2019

Abstract

The aim: To evaluate the long-term dynamics of health losses caused by ambulatory care sensitive conditions (ACSCs) to justify the priorities of public policy regarding this group of diseases. Materials and methods: The data used were obtained from the Institute of Health Metrics and Evaluation, the European database “Health for All”, for 1990-2019. The study was conducted using bibliosemantic, historical and epidemiological study methods. Results: Disability-adjusted life years (DALYs) due to ACSC over 30 years in Ukraine averaged 5145.4 years per 100,000 population (95% CI 4731.1 -5559.7), which is approximately 14% of DALYs of all reasons without a clear trend of change - compound annual growth rate (CARG) of 0.14%. These five causes –angina pectoris, chronic obstructive pulmonary diseases (COPD), lower respiratory infections, diabetes, and tuberculosis – account for 90% of the disease burden associated with ACSCs. There was an increasing trend in DALYs (CARG varied for different ACSCs in the range of 0.59-1.88%), except for COPD, where the decrease in CARG reached -3.16%. Conclusions: This longitudinal study found a small trend toward increased DALYs due to ACSCs. State measures to influence modified risk factors to reduce the burden of losses from ACSCs proved to be ineffective. To significantly reduce DALYs, a more clear and more systematic healthcare policy regarding ACSCs is needed, which includes a set of primary prevention measures, and organizational and economic strengthening of the primary health care.