Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019.
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State: Public
Version: Final published version
License: Not specified
Serval ID
serval:BIB_0353ACA0D6B6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019.
Journal
The Lancet. Global health
Working group(s)
GBD 2019 Healthcare Access and Quality Collaborators
Contributor(s)
Yearwood J.A., Fullman N., Bintz C., Bienhoff K., Weaver M.R., Nandakumar V., Joffe J.N., LeGrand K.E., Knight M., Abbafati C., Abbasi-Kangevari M., Abdoli A., Abeldaño Zuñiga R.A., Adedeji I.A., Adekanmbi V., Adetokunboh O.O., Afzal M.S., Afzal S., Agudelo-Botero M., Ahinkorah B.O., Ahmad S., Ahmadi A., Ahmadi S., Ahmed A., Ahmed Rashid T., Aji B., Akande-Sholabi W., Alam K., Al Hamad H., Alhassan R.K., Ali L., Alipour V., Aljunid S.M., Ameyaw E.K., Amin T.T., Amu H., Amugsi D.A., Ancuceanu R., Andrade P.P., Anjum A., Arabloo J., Arab-Zozani M., Ariffin H., Arulappan J., Aryan Z., Ashraf T., Atnafu D.D., Atreya A., Ausloos M., Avila-Burgos L., Ayano G., Ayanore M.A., Azari S., Badiye A.D., Baig A.A., Bairwa M., Bakkannavar S.M., Baliga S., Banik P.C., Bärnighausen T.W., Barra F., Barrow A., Basu S., Bayati M., Belete R., Bell A.W., Bhagat D.S., Bhagavathula A.S., Bhardwaj P., Bhardwaj N., Bhaskar S., Bhattacharyya K., Bhutta Z.A., Bibi S., Bijani A., Bikbov B., Biondi A., Bolarinwa O.A., Bonny A., Brenner H., Buonsenso D., Burkart K., Busse R., Butt Z.A., Butt N.S., Caetano Dos Santos F.L., Cahuana-Hurtado L., Cámera L.A., Cárdenas R., Carneiro VLA, Catalá-López F., Chandan J.S., Charan J., Chavan P.P., Chen S., Chen S., Choudhari S.G., Chowdhury E.K., Chowdhury MAK, Cirillo M., Corso B., Dadras O., Dahlawi SMA, Dai X., Dandona L., Dandona R., Dangel W.J., Dávila-Cervantes C.A., Davletov K., Deuba K., Dhimal M., Dhimal M.L., Djalalinia S., Do H.P., Doshmangir L., Duncan B.B., Effiong A., Ehsani-Chimeh E., Elgendy I.Y., Elhadi M., El Sayed I., El Tantawi M., Erku D.A., Eskandarieh S., Fares J., Farzadfar F., Ferrero S., Ferro Desideri L., Fischer F., Foigt N.A., Foroutan M., Fukumoto T., Gaal P.A., Gaihre S., Gardner W.M., Garg T., Getachew Obsa A., Ghafourifard M., Ghashghaee A., Ghith N., Gilani S.A., Gill P.S., Goharinezhad S., Golechha M., Guadamuz J.S., Guo Y., Gupta R.D., Gupta R., Gupta V.K., Gupta V.B., Hamiduzzaman M., Hanif A., Haro J.M., Hasaballah A.I., Hasan M.M., Hasan M.T., Hashi A., Hay S.I., Hayat K., Heidari M., Heidari G., Henry N.J., Herteliu C., Holla R., Hossain S., Hossain S.J., Hossain MBH, Hosseinzadeh M., Hostiuc S., Hoveidamanesh S., Hsieh V.C., Hu G., Huang J., Huda M.M., Ifeagwu S.C., Ikuta K.S., Ilesanmi O.S., Irvani SSN, Islam R.M., Islam SMS, Ismail N.E., Iso H., Isola G., Itumalla R., Iwagami M., Jahani M.A., Jahanmehr N., Jain R., Jakovljevic M., Janodia M.D., Jayapal S.K., Jayaram S., Jha R.P., Jonas J.B., Joo T., Joseph N., Jürisson M., Kabir A., Kalankesh L.R., Kalhor R., Kamath A.M., Kamenov K., Kandel H., Kantar R.S., Kapoor N., Karanikolos M., Katikireddi S.V., Kavetskyy T., Kawakami N., Kayode G.A., Keikavoosi-Arani L., Keykhaei M., Khader Y.S., Khajuria H., Khalilov R., Khammarnia M., Khan M.N., Khan M.A., Khan M., Khezeli M., Kim M.S., Kim Y.J., Kisa S., Kisa A., Klymchuk V., Koly K.N., Korzh O., Kosen S., Koul P.A., Kuate Defo B., Kumar G.A., Kusuma D., Kyu H.H., Larsson A.O., Lasrado S., Lee W.C., Lee Y.H., Lee C.B., Li S., Lucchetti G., Mahajan P.B., Majeed A., Makki A., Malekzadeh R., Malik A.A., Malta D.C., Mansournia M.A., Mantovani L.G., Martinez-Valle A., Martins-Melo F.R., Masoumi S.Z., Mathur M.R., Maude R.J., Maulik P.K., McKee M., Mendoza W., Menezes R.G., Mensah G.A., Meretoja A., Meretoja T.J., Mestrovic T., Michalek I.M., Mirrakhimov E.M., Misganaw A., Misra S., Moazen B., Mohammadi M., Mohammed S., Moitra M., Mokdad A.H., Molokhia M., Monasta L., Moni M.A., Moradi G., Moreira R.S., Mosser J.F., Mostafavi E., Mouodi S., Nagarajan A.J., Nagata C., Naghavi M., Nangia V., Narasimha Swamy S., Narayana A.I., Nascimento B.R., Nassereldine H., Nayak B.P., Nazari J., Negoi I., Nepal S., Neupane Kandel S., Ngunjiri J.W., Nguyen HLT, Nguyen C.T., Ningrum DNA, Noubiap J.J., Oancea B., Oghenetega O.B., Oh I.H., Olagunju A.T., Olakunde B.O., Omar Bali A., Omer E., Onwujekwe O.E., Otoiu A., Padubidri J.R., Palladino R., Pana A., Panda-Jonas S., Pandi-Perumal S.R., Pardhan S., Pasupula D.K., Pathak P.K., Patton G.C., Pawar S., Pereira J., Pilania M., Piroozi B., Podder V., Pokhrel K.N., Postma M.J., Prada S.I., Quazi Syed Z., Rabiee N., Radhakrishnan R.A., Rahman M.M., Rahman M., Rahman M., Rahman MHU, Rahmani A.M., Ranabhat C.L., Rao C.R., Rao S.J., Rasella D., Rawaf S., Rawaf D.L., Rawal L., Renzaho AMN, Reshmi B., Resnikoff S., Rezapour A., Riahi S.M., Ripon R.K., Sacco S., Sadeghi M., Saeed U., Sahebkar A., Sahiledengle B., Sahoo H., Sahu M., Salama J.S., Salamati P., Samy A.M., Sanabria J., Santric-Milicevic M.M., Sathian B., Sawhney M., Schmidt M.I., Seidu A.A., Sepanlou S.G., Seylani A., Shaikh M.A., Sheikh A., Shetty A., Shigematsu M., Shiri R., Shivakumar K.M., Shokri A., Singh J.A., Sinha D.N., Skryabin V.Y., Skryabina A.A., Sofi-Mahmudi A., Sousa RARC, Stephens J.H., Sun J., Szócska M., Tabarés-Seisdedos R., Tadbiri H., Tamiru A.T., Thankappan K.R., Topor-Madry R., Tovani-Palone M.R., Tran MTN, Tran B.X., Tripathi N., Tripathy J.P., Troeger C.E., Uezono D.R., Ullah S., Ullah A., Unnikrishnan B., Vacante M., Valadan Tahbaz S., Valdez P.R., Vasic M., Veroux M., Vervoort D., Violante F.S., Vladimirov S.K., Vlassov V., Vo B., Waheed Y., Wamai R.G., Wang Y.P., Wang Y., Ward P., Wiangkham T., Yadav L., Yahyazadeh Jabbari S.H., Yamagishi K., Yaya S., Yazdi-Feyzabadi V., Yi S., Yiğit V., Yonemoto N., Younis M.Z., Yu C., Yunusa I., Zaman S.B., Zastrozhin M.S., Zhang Z.J., Zhong C., Zuniga YMH, Lim S.S., Murray CJL, Lozano R.
ISSN
2214-109X (Electronic)
ISSN-L
2214-109X
Publication state
Published
Issued date
12/2022
Peer-reviewed
Oui
Volume
10
Number
12
Pages
e1715-e1743
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019.
We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development.
Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9-21·3), as well as among the young (22·5, 19·9-24·7), working (17·2, 15·2-19·1), and post-working (15·1, 13·2-17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6-33·0) on average in low-SDI countries to 83·4 (82·4-84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4-89·0), working (33·8-82·8), and post-working (30·4-79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries.
Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young.
Bill & Melinda Gates Foundation.
We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development.
Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9-21·3), as well as among the young (22·5, 19·9-24·7), working (17·2, 15·2-19·1), and post-working (15·1, 13·2-17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6-33·0) on average in low-SDI countries to 83·4 (82·4-84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4-89·0), working (33·8-82·8), and post-working (30·4-79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries.
Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young.
Bill & Melinda Gates Foundation.
Keywords
Adolescent, Adult, Aged, Child, Child, Preschool, Humans, Infant, Infant, Newborn, Middle Aged, Young Adult, Global Burden of Disease, Global Health, Health Services Accessibility, Quality of Health Care, Quality-Adjusted Life Years, Risk Factors
Pubmed
Web of science
Open Access
Yes
Create date
10/05/2023 15:35
Last modification date
25/01/2024 8:30
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