Global and regional quality of care index (QCI) by gender and age in oesophageal cancer: A systematic analysis of the Global Burden of Disease Study 1990-2019

BACKGROUND

The aim of this study was to examine the quality of care by age and gender in oesophageal cancer using Global Burden of Disease (GBD) database.

METHODS

Patients aged 20 and over with oesophageal cancer were included in this longitudinal study using GBD 1990-2019 data. We used the Socio-Demographic Index (SDI) to classify the regions. We used Principal Component Analysis (PCA) method to calculate the Quality of Care Index (QCI). The QCI was rescaled into a 0-100 single index, demonstrating that the higher the score, the better the QC.

RESULTS

The age-standardized QCI for oesophageal cancer dramatically increased from 23.5 in 1990 to 41.1 in 2019 for both sexes, globally. The high SDI regions showed higher QCI than the rest of the regions (45.1 in 1990 and 65.7 in 2019) whereas the low SDI regions had the lowest QCI, which showed a 4.5% decrease through the years (from 13.3 in 1990 to 12.7 in 2019). Globally, in 2019, the QCI showed the highest scores for patients aged 80-84, reported 48.2, and the lowest score for patients aged 25-29 reported 31.5, for both sexes. Globally, in 2019, age-standardized Gender Disparity Ratio (GDR) was 1.2, showing higher QCI in females than males.

CONCLUSION

There were fundamental differences in the QCI both globally and regionally between different age groups as well as between males and females. To achieve the goal of providing high-quality services equally to people in need in all over the world, health systems need to invest in effective diagnostic services, treatments, facilities, and equipment and to plan for screening and surveillance of high-risk individuals.

The Attitudes of Men and Women concerning Gender Differences in Grief

Attitudes concerning gender and grief were investigated using a convenience sample of 106 men and women ages 23 to 82 years. Participants rated conjugal grief behaviors of target figures for sympathy and appropriateness on the Attitudes Toward Gender and Grief Scale, rated their own sex-role type on the Bem Sex Role Inventory, and provided demographic information and a brief grief history. Results from factor analysis of the Attitudes Toward Gender and Grief Scale showed evidence for the construct validity of the scale by yielding three factors: sympathy, appropriateness of instrumental grief, and appropriateness of intuitive grief. The hypothesis that factor analysis of the Attitudes Toward Gender and Grief Scale would show that vignettes describing gender-stereotypical grief behavior would load positively on factors for sympathy and appropriateness was not confirmed. However, the hypothesis that female participants would give more sympathy to grieving people than males was confirmed. Contrary to expectation, participants did not give female target figures more sympathy than male figures; women did not give the most sympathy to female target figures; and men did not give male target figures the least sympathy. As hypothesized, feminine sex-typed and androgynous participants gave more sympathy to grieving people than masculine sex-typed participants. Findings were discussed in terms of evolutionary, developmental, and sex-role socialization theories.