Global, regional, and national burden and quality of care index (QCI) of bipolar disorder: A systematic analysis of the Global Burden of Disease Study 1990 to 2019

BACKGROUND

Bipolar disorders (BD) are significant debilitating mental problems. Here, we introduced a novel index as a representative of the quality of care delivered to BD patients worldwide.

METHODS

The Global Burden of Disease (GBD) 2019 study was the primary data source on BD, including prevalence, incidence, and years lived with disability (YLDs). Secondary indices were created and transformed into a single component that accounted for most of the variation, using the Principal Component Analysis (PCA) method. This component, reported on a scale of 0 to 100, was presented as the quality of care index (QCI). The QCI was estimated in different age groups and areas within a 30-year time frame. Gender disparity ratio (GDR), as the female-to-male ratio of the QCI, was reported.

RESULTS

The Global QCI slightly increased from 50.4 in 1990 to 53.1 in 2019. The GDR value was 0.95 in 2019. The high-middle SDI quintile had the highest QCI estimate of 63.0, and the lowest QCI value of 36.9 was regarding the low SDI quintile. Western-Pacific Region and South-East Asia had the highest and lowest QCI among WHO regions, with estimates of 70.7 and 31.2, respectively. The age group of 20 to 24 years old patients reported the lowest QCI estimate of 30.2, and the highest QCI of 59.8 was regarding 40 to 44 years old patients.

CONCLUSION

The QCI in BD had only a subtle increase from 1990 to 2019 and is in need of further improvement. Inequalities between different regions and age groups are considerable and require proper attention.

Global and regional quality of care index for prostate cancer: an analysis from the Global Burden of Disease study 1990-2019

BACKGROUND

Prostate cancer (PCa) is one of the most prevalent cancers worldwide, with a significant burden on societies and healthcare providers. We aimed to develop a metric for PCa quality of care that could demonstrate the disease's status in different countries and regions (e.g., socio-demographic index (SDI) quintiles) and assist in improving healthcare policies.

METHODS

Basic burden of disease indicators for various regions and age-groups were retrieved from Global Burden of Disease Study 1990-2019, which then were used to calculate four secondary indices: mortality to incidence ratio, DALYs to prevalence ratio, prevalence to incidence ratio, and YLLs to YLDs ratio. These four indices were combined through a principal component analysis (PCA), producing the quality of care index (QCI).

RESULTS

PCa's age-standardized incidence rate increased from 34.1 in 1990 to 38.6 in 2019, while the age-standardized death rate decreased in the same period (18.1 to 15.3). From 1990 to 2019, global QCI increased from 74 to 84. Developed regions (high SDI) had the highest PCa QCIs in 2019 (95.99), while the lowest QCIs belonged to low SDI countries (28.67), mainly from Africa. QCI peaked in age groups 50 to 54, 55 to 59, or 65 to 69, depending on the socio-demographic index.

CONCLUSIONS

Global PCa QCI stands at a relatively high value (84 in 2019). Low SDI countries are affected the most by PCa, mainly due to the lack of effective preventive and treatment methods in those regions. In many developed countries, QCI decreased or stopped rising after recommendations against routine PCa screening in the 2010-2012 period, highlighting the role of screening in reducing PCa burden.