Objective To investigate the association between costs of hospitalized patients with diabetes mellitus and their complications in the West China Hospital of Sichuan University, so as to provide baseline data for further research. Methods We extracted the hospitalization case data of hospitalized patients with diabetes mellitus who were discharged from the department of endocrinology and metabolism, or discharged after being transferred to other departments for treatment from January 2011 to December 2012, using the hospital information system (HIS) of the West China Hospital of Sichuan University. The data included baseline of hospital patients, discharge diagnosis, hospitalization costs, and if their medical insurance had been registered in hospital. Then, we classified the diseases according to ICD-10 based on discharge diagnosis, coped the data using Excel 2010 software, and conducted statistical analysis using SPSS 13.0. Results a) In 2011, acute and chronic diabetes complication in diabetes inpatients were 11.9% (166/1 396) and 67.1% (930/1 396), respectively. Most of them had peripheral neuropathy and peripheral vascular disease. b) The most frequently-occurred complications were hypertension, followed by dyslipidemia, and osteoporosis. c) The median hospital stay was 13 days (7 to 9 days), and the median total cost of hospital/person-time was 6 578.88 yuan (4 186.93 to 10 953.89 yuan). d) The total cost and duration of hospitalization increased along with the increasing number of the chronic complications of diabetes. e) The diabetic foot patients were 255 person-times, the median duration of hospitalization was 18 days (13 to 29 days), and the median total cost of hospital/person-time was 16 672.19 yuan (10 903.93 to 28 530.37 yuan). Diabetes patients with foot complication had higher total costs and longer duration of hospitalization than those without foot complication. Conclusion Diabetes mellitus is one of the most important diseases in the department of endocrinology and metabolism, which is heavy disease burden. The costs of hospitalization and chronic complications are closely associated. Among these complications, diabetic foot is the heaviest disease burden.
ObjectivesTo systematically review the prevalence and disease burden of knee osteoarthritis (KOA) in China.MethodsPubMed, EMbase, CNKI, WanFang Data and VIP databases were searched to collect cross-sectional studies about the prevalence and disease burden of KOA in China from January 1st 1995 to August 31st 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using R statistical software.ResultsA total of thirty-three studies were included. The results of meta-analysis showed the prevalance rate of KOA was 18% (95%CI 14% to 22%), and it was higher in women (19%, 95%CI 16% to 23%) than in men (11%, 95%CI 9% to 13%) (P<0.05). The prevalence rates of KOA in different regions were as follows: 11% (95%CI 8% to 14%) in north, 17% (95%CI 15% to 20%) in north-east, 21% (95%CI 13% to 32%) in east, 21% (95%CI 13% to 33%) in north-west, 22% (95%CI 6% to 57%) in south-west, and 18% (95%CI 13% to 23%) in south-central, respectively.ConclusionsThe prevalence of KOA in China is high, and the disease burden is heavy. Due to the quantity and quality of included studies, more high-quality studies are required to verify the above conclusions in future.
Objective To investigate financial burden of in-patients with hypothalamus-pituitary-adrenal gland/gonad diseases in the West China Hospital of Sichuan University, 2011, so as to provide baseline data for further research. Methods The data of in-patients (who had been discharged from the department of endocrinology and metabolism or discharged after being transferred to other departments for diagnosis and treatment in the West China Hospital in 2011) were collected from the Hospital Information System (HIS) of the West China Hospital, including basic information, initial diagnosis when the patients were discharged, hospital costs, the information about whether the patients had been registered the insurance in hospital, etc. We classified diseases according to ICD-10 based on the initial diagnosis when the patients were discharged on the first page of case reports. The data were input using Excel 2010 software, and statistical analysis was performed using SPSS 13.0 software. Results The results showed that: in 2011, 352 person-times of in-patients with hypothalamus-pituitary-adrenal gland/gonad disease as first diagnosis were hospitalized in the department of endocrinology and metabolism, of which, 139 were male and 213 were female, with mean age of 42.9±15.0 years; and b) median hospital stay was 11 days, the average cost of hospital stay for each patient was RMB 4 361.09 yuan, most of which was for lab tests, examination, and biomedicine cost. Conclusion Hypothalamus-pituitary-adrenal gland/gonad diseases are an important health problem in the department of endocrinology and metabolism in a Triple-A Hospital. Most of hospitalization costs are for lab tests, examination, and biomedicine cost.
ObjectiveThis study intends to analyze the changing disease burden of mood disorders in China from 1990 to 2021 and project the epidemiological trends in the next two decades. MethodsThis study uses data from the Global Burden of Disease (GBD) 2021 database on three mood disorders in China (bipolar disorder, major depressive disorder, and dysthymia) from 1990 to 2021. The indicators such as age-standardized number of diseases and disability-adjusted life years (DALYs) were used to explore the characteristics of time, gender, and age distribution of the disease burden of mental disorders. The BAPC model was used to predict the disease burden in the next two decades. ResultsIn 2021, the number of cases of dysthymia, MDD, and BD in China was 27.84 million, 26.0 million, and 2.85 million, with an increase of 73.24%, 38.33%, and 36.79% compared with 1990, respectively. In 2021, DALYs of dysthymic disorder, MDD and BD were 2.67 million, 5.2 million and 0.61 million person-years, which increased by 71.45%, 34.29% and 34.76% compared with 1990, respectively. The burden of mood disorders is heavier among women and the middle-aged and elderly population. In addition, it is expected that ASPR and ASDR of dysthymia will continue to increase after a brief decline, MDD will show a downward trend, while BD will show a slight upward trend in the next two decades. ConclusionThe disease burden of mood disorders in China remains substantial, with dysthymia and BD showing persistent upward tendency. More resources should be invested in mental health care.
ObjectivesTo conduct a bibliometric analysis to research the status of disease burden domestically and overseas so as to understand the status of diseases burden, and to provide scientific and reasonable reference for health disease prevention, control strategies formulation and future research.MethodsPubMed, Web of Science, EMbase, The Cochrane Library, WanFang Data, CBM and CNKI databases were electronically searched to collect literature on disease burden from inception to October, 2018. Two reviewers independently screened literature and extracted data. EndNote X7 software was used for literature management, Excel 2016 software and VOS viewer software were also used to analyze data. Literature was classified by the aspects of literature publication characteristics, diseases, background areas, influencing factors, evaluation indicators and poverty caused by illness.ResultsA total of 325 studies were included in the bibliometric analysis. 41 articles (12.6%) were published in journals indexed by SCIE; original research evidence accounted for 97.0% (315 articles); 272 articles were from China (83.7%). The main diseases involved were malignant tumors (58 articles, 17.8%), diabetes (29 articles, 8.9%) and hypertension (24 articles, 7.4%). Factors affecting the disease burden primarily included hospitalization days (9 articles, 2.8%), complications (5 articles, 1.5%), delays in treatment (5 articles, 1.5%), and economic income (4 articles, 1.2%). Sixity-one articles (18.8%) reported poverty due to illness, and related diseases were chronic obstructive pulmonary disease (12 articles, 3.7%), hypertension (10 articles, 3.1%), diabetes (10 articles, 3.1%), malignant tumors (9 articles, 2.8%) and hepatitis B (6 articles, 1.8%).ConclusionsAt present, the disease burden research are focusing more on the burden of chronic non-communicable diseases such as malignant tumors, hypertension, diabetes, cardiovascular and cerebrovascular diseases in developing countries and regions. Medical costs vary from different diseases and treatment, different demographic characteristics of patients, and the coverage medical security of different population are the primary reasons for the " expensive in medical treatment” of current residents and the heavy burden of disease. DALY and total direct medical expenses are the main evaluation indexes of epidemiological burden and economic burden of disease, respectively. Future researches should focus on strengthening the scientific nature of study design to improve the quality of research, as well as paying more attention to diseases and aspects that are rarely involved, such as major diseases caused by poverty due to illness, comprehensive analysis of multiple diseases and aspects of health investment measurement, and comprehensively use the evaluation indicators of disease burden to strengthen the research on the comparability index of disease economic burden.
ObjectiveThe aim of this study was to assess the disease burden of non-COVID-19 lower respiratory infection (LRI) in China during the period 1990−2021, particularly during the period 2019−2021. MethodsData on the burden of disease for LRI in China were obtained from the GBD 2021 database. A Joinpoint regression model was used to describe the changes in disease burden trends of LRI in China from 1990 to 2021, and the results are presented in terms of average annual percentage change (AAPC). ResultsIn 2021, the age-standardized incidence rate of LRI in China was 2 853.31/100 000, the age-standardized rate of DALY was 347.67/100 000, and the age-standardized mortality rate was 14.03/100 000. Compared with 1990, the AAPC were −2.13%, −6.89% and −4.10% respectively. In contrast, during the COVID-19 pandemic, both showed a decreasing and then increasing trend, except for the age-standardized incidence rate, which showed a decreasing trend. Children under 5 years of age have experienced the greatest reduction in the burden of disease over the past decades, while the burden of disease has increased in absolute terms for the elderly over 70 years of age. Compared with 1990, the disease burden of LRI in China due to each pathogenic microorganism has decreased. And during 2019−2021, all pathogens showed an increasing trend, except for ASMR caused by influenza (APC=−55.21%) and respiratory syncytial virus (APC=−53.35%). In 2021, the primary attributable risk factors for LRI mortality in China shifted from household air pollution due to solid fuels, childhood underweight, and childhood stunting in 1990 to ambient particulate matter pollution, smoking, and secondhand smoke. ConclusionThe disease burden of LRIs in China showed an overall decreasing trend from 1990 to 2021, but with large variations between age groups and pathogens. During the two years following the outbreak of the COVID-19 pandemic, the incidence of LRI in China, along with the disease burden caused by influenza and respiratory syncytial virus, significantly declined. Over the past few decades, the attributable risk factors for mortality and DALYs have undergone substantial changes. To address this phenomenon, targeted measures should be implemented to reduce the burden of LRI on the population caused by air pollution and smoking.
ObjectiveTo analyze the trend of chronic kidney disease (CKD) disease burden attributable to metabolic factors in China from 1990 to 2021, and to predict the death of CKD due to metabolic factors in China from 2022 to 2046. MethodsBased on the 2021 Global Burden of Disease Database, this paper collected and sorted out the CKD deaths, disability-adjusted life years (DALYs), premature death lost life years (YLLs), and disability life lost years (YLDs) attributed to metabolic factors by different ages and sexes in China from 1990 to 2021, and used the Joinpoint regression model to systematically evaluate the temporal trends of standardized mortality and standardized DALYs rate. The age-period-cohort (APC) model was used to assess age, period, and cohort effects, and the R software Nordpred package was used to predict future changes in the burden of disease. ResultsCompared with 1990, the mortality rate, DALYs rate, YLLs rate, and YLDs rate attributable to metabolic factors of Chinese residents in 2021 showed an upward trend, and the characteristics of male higher than female, higher age group than lower age group. The primary metabolic factor influencing the disease burden of CKD was hyperglycemia. The results of Joinpoint analysis showed a downward trend in the standardized mortality and standardized DALYs rate of CKD attributed to metabolic factors. The results of age-period-cohort model analysis showed that the age effect of CKD attributed to metabolic factors increased significantly, the period effect increased slowly, and the cohort effect showed a downward trend. ConclusionThe disease burden of CKD attributed to metabolic factors in China is generally on the rise, and men, the elderly, and diabetic patients are the key focus of the disease.
Objective To summarize and categorize the epidemiological evaluation indicators of disease burden, and to explore and analyze the research gaps in the existing evaluation indicators of disease burden. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science and Cochrane Library databases were searched by computer to obtain qualitative studies on evaluation indicators of disease burden. The search time limit was from the establishment of the database to October 2023. CASP was used to evaluate the methodological quality of the included studies, and thematic analysis was used to summarize the evaluation indicators of disease burden by NVivo 12 software. Results A total of 19 studies were included, of which 10 studies were of high quality and 9 studies were of medium quality. The evaluation indicators of disease burden were summarized into two three-level core themes: positive indicators and negative indicators. Five second-level analytic themes were used: disease indicators, life loss indicators, life expectancy indicators, cause removal indicators and health status indicators. Twenty-nine level-1 descriptive themes. Conclusion The evaluation indicators of disease burden have their respective scopes of application and limitations. It is necessary to continue strengthening the construction of a comprehensive evaluation index system for disease burden, so that it is comparable and reliable, can adapt to local calculation weights, and covers both family burden and social burden.
Objective To analyze the trend of changes in the burden of liver cancer diseases attributed to alcohol consumption in China from 1990 to 2019. Methods Data on liver cancer burden attributed to drinking in China from 1990 to 2019 were obtained from the global burden of disease 2019. Joinpoint regression model was used to analyze the temporal trend of disease burden, and age-period-cohort model was used to evaluate age, period, and cohort effects. Results From 1990 to 2019, the standardized incidence rate of liver cancer attributable to drinking among the total population, men and women showed a downward trend. The AAPC was −2.52% (95%CI −2.83% to −2.21%), 3.26% (95%CI −3.62% to −2.89%) and −2.24% (95%CI −2.61% to −1.86%), respectively; The standardized mortality rates showed a decreasing trend, with AAPC values of −2.86% (95%CI −3.46% to −2.26%), −3.48% (95%CI −4.20% to −2.76%), and −2.67% (95%CI −2.99% to −2.34%), respectively; The standardized DALY rates showed a downward trend, with AAPC values of −3.09% (95%CI −3.65% to −2.53%), −2.92% (95%CI −3.25% to −2.58%), and −3.77 (95%CI −4.21% to −3.31%), respectively. The trend changes were statistically significant (P<0.05). From 1990 to 2019, the overall risk of liver cancer incidence and death attributed to drinking in China, both in males and females, showed a trend of first increasing and then decreasing with age; As the period increased, both the overall population and the male population showed a downward trend, followed by an upward trend, while the female population remained relatively stable; The lower the risk of liver cancer incidence and death attributed to drinking as the queue progressed. Conclusion The standardized incidence rate, mortality and DALY rates of liver cancer attributable to drinking in China are generally declining, we should strengthen health education and early diagnosis and treatment for both male and elderly people to reduce the burden of liver cancer.
In China, there are more than 2 million new strokes annually, and the disability-adjusted life-years due to stroke were higher than any other disease. With aging of the population, inadequate control of vascular risk factors such as hypertension, and uneven distribution of specialized stroke care, the burden of stroke will continue to increase. Despite improved health care quality in China, the availability of specialized stroke care varies across the country, especially in rural areas. Stroke prevention, management and research face unique and severe challenges due to rough terrain and economic underdevelopment in Southwest China. In the future, efforts should be made to provide more balanced availability of specialized stroke care services across China, promote generalization of evidence-based practice, and carry out more high-quality research to improve outcomes of stroke patients, with special attention to the rural population and Southwest China.