Background::Non-transport unintentional injuries(NTUIs)are major public concerns,especially among children and adolescents in low-and middle-income countries.With environmental and cognitive changes,a recent systemati...Background::Non-transport unintentional injuries(NTUIs)are major public concerns,especially among children and adolescents in low-and middle-income countries.With environmental and cognitive changes,a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings.Methods::We used mortality,population,and socio-demographic-index(SDI)data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality.We applied the slope index of inequality(SII)and relative index of inequality(RII)to measure the absolute and relative inequality between countries and territories.The concentration curve and concentration index(CI)were also used to measure the inequality.We conducted a sensitivity analysis to make our findings credible.Results::In 2019,there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years,which decreased from 375,000 in 1990.In 2019,the age-standardized mortality rate(ASMR)was 8.13 per 100,000,ranging from the lowest in the Netherlands(0.90 per 100,000)to the highest in the Solomon Islands(29.34 per 100,000).The low-middle SDI group had the highest ASMR of NTUIs,while the low SDI group had the slowest decrease.After excluding the death caused by"exposure to forces of nature"and"other unintentional injuries",drowning accounted for the most deaths in almost every SDI group,gender,and age group,but the major causes of death varied in different subgroups.For example,animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups,while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings.The SII showed a declining trend,but the RII and CI did not,which might indicate that inequality was persistent.Similar results were found in the sensitivity analysis.Conclusions::Despite the declining trend of the mortality rate and the narrowing gap between countries,there were still a large n展开更多
医疗可及性和质量(healthcare access and quality index,HAQ)是反映医疗系统及时、有效地发现、管理、治疗从而避免疾病死亡能力的重要指标.本研究利用2015年全球疾病负担研究结果,比较2015年中国与全球主要国家的HAQ指数差异,同时分析...医疗可及性和质量(healthcare access and quality index,HAQ)是反映医疗系统及时、有效地发现、管理、治疗从而避免疾病死亡能力的重要指标.本研究利用2015年全球疾病负担研究结果,比较2015年中国与全球主要国家的HAQ指数差异,同时分析1990~2015年期间中国疾病间、省级行政区间HAQ指数及其变化幅度的差异.2015年中国HAQ指数为74.2分,高出全球平均水平20.5分;中国HAQ指数与其期望值仅相差1.2分,此差距远低于全球平均水平(20.1分).1990~2015年中国在呼吸系统疾病(上呼吸道感染、慢性呼吸系统疾病)、计划免疫性疾病(白喉、百日咳、破伤风和麻疹)、通过常规手术治愈的疾病(阑尾炎和腹股沟、股骨和腹部疝)、孕产妇疾病、缺血性心脏病和医疗副作用表现出较高的HAQ.2015年北京、澳门、上海等9个省级行政区的HAQ指数达到80分以上;西藏、青海、贵州、新疆和云南的HAQ指数最低;且处于高和中高社会人口发展水平的大部分省级行政区,其HAQ指数均高于其相应的期望值.1990~2015年中国HAQ指数增长49.30%,其中长幅最大的省级行政区为新疆、江西、云南和陕西,均超过55%;长幅最小的省级行政区为西藏、香港和澳门.研究表明,1990~2015年间,中国医疗可及性和质量有较大程度的提高,但在不同疾病领域、不同省级行政区表现出的医疗可及性和质量及其改善程度差异较大.展开更多
基金This study was supported by grants from the National Statistical ScientificResearch Program(No.2021LY052)the China Medical Board(21-434 to YS)the National Natural Science Foundation of China(No.82073573).
文摘Background::Non-transport unintentional injuries(NTUIs)are major public concerns,especially among children and adolescents in low-and middle-income countries.With environmental and cognitive changes,a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings.Methods::We used mortality,population,and socio-demographic-index(SDI)data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality.We applied the slope index of inequality(SII)and relative index of inequality(RII)to measure the absolute and relative inequality between countries and territories.The concentration curve and concentration index(CI)were also used to measure the inequality.We conducted a sensitivity analysis to make our findings credible.Results::In 2019,there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years,which decreased from 375,000 in 1990.In 2019,the age-standardized mortality rate(ASMR)was 8.13 per 100,000,ranging from the lowest in the Netherlands(0.90 per 100,000)to the highest in the Solomon Islands(29.34 per 100,000).The low-middle SDI group had the highest ASMR of NTUIs,while the low SDI group had the slowest decrease.After excluding the death caused by"exposure to forces of nature"and"other unintentional injuries",drowning accounted for the most deaths in almost every SDI group,gender,and age group,but the major causes of death varied in different subgroups.For example,animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups,while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings.The SII showed a declining trend,but the RII and CI did not,which might indicate that inequality was persistent.Similar results were found in the sensitivity analysis.Conclusions::Despite the declining trend of the mortality rate and the narrowing gap between countries,there were still a large n
文摘医疗可及性和质量(healthcare access and quality index,HAQ)是反映医疗系统及时、有效地发现、管理、治疗从而避免疾病死亡能力的重要指标.本研究利用2015年全球疾病负担研究结果,比较2015年中国与全球主要国家的HAQ指数差异,同时分析1990~2015年期间中国疾病间、省级行政区间HAQ指数及其变化幅度的差异.2015年中国HAQ指数为74.2分,高出全球平均水平20.5分;中国HAQ指数与其期望值仅相差1.2分,此差距远低于全球平均水平(20.1分).1990~2015年中国在呼吸系统疾病(上呼吸道感染、慢性呼吸系统疾病)、计划免疫性疾病(白喉、百日咳、破伤风和麻疹)、通过常规手术治愈的疾病(阑尾炎和腹股沟、股骨和腹部疝)、孕产妇疾病、缺血性心脏病和医疗副作用表现出较高的HAQ.2015年北京、澳门、上海等9个省级行政区的HAQ指数达到80分以上;西藏、青海、贵州、新疆和云南的HAQ指数最低;且处于高和中高社会人口发展水平的大部分省级行政区,其HAQ指数均高于其相应的期望值.1990~2015年中国HAQ指数增长49.30%,其中长幅最大的省级行政区为新疆、江西、云南和陕西,均超过55%;长幅最小的省级行政区为西藏、香港和澳门.研究表明,1990~2015年间,中国医疗可及性和质量有较大程度的提高,但在不同疾病领域、不同省级行政区表现出的医疗可及性和质量及其改善程度差异较大.
