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Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China

OBJECTIVES: To measure the disease burden of ageing based on age-related diseases (ARDs), the sex and regional disparities and the impact of health resources allocation on the burden in China. DESIGN: A national comparative study based on Global Burden of Diseases Study estimates and China’s routine...

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Autores principales: Chen, Shu, Si, Yafei, Hanewald, Katja, Li, Bingqin, Bateman, Hazel, Dai, Xiaochen, Wu, Chenkai, Tang, Shenglan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670959/
https://www.ncbi.nlm.nih.gov/pubmed/36385040
http://dx.doi.org/10.1136/bmjopen-2022-064641
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author Chen, Shu
Si, Yafei
Hanewald, Katja
Li, Bingqin
Bateman, Hazel
Dai, Xiaochen
Wu, Chenkai
Tang, Shenglan
author_facet Chen, Shu
Si, Yafei
Hanewald, Katja
Li, Bingqin
Bateman, Hazel
Dai, Xiaochen
Wu, Chenkai
Tang, Shenglan
author_sort Chen, Shu
collection PubMed
description OBJECTIVES: To measure the disease burden of ageing based on age-related diseases (ARDs), the sex and regional disparities and the impact of health resources allocation on the burden in China. DESIGN: A national comparative study based on Global Burden of Diseases Study estimates and China’s routine official statistics. SETTING AND PARTICIPANTS: Thirty-one provinces of Mainland China were included for analysis in the study. No individuals were involved. METHODS: We first identified the ARDs and calculated the disability-adjusted life years (DALYs) of ARDs in 2016. We assessed the ARD burden disparities by province and sex and calculated the provincial ARD burden-adjusted age. We assessed historical changes between 1990 and 2016. Fixed effects regression models were adopted to evaluate the impact of health expenditures and health workforce indicators on the ARD burden in 2010–2016. RESULTS: In 2016, China’s total burden of ARDs was 15 703.7 DALYs (95% uncertainty intervals: 12 628.5, 18 406.2) per 100 000 population. Non-communicable diseases accounted for 91.9% of the burden. There were significant regional disparities. The leading five youngest provinces were Beijing, Guangdong, Shanghai, Zhejiang and Fujian, located on the east coast of China with an ARD burden-adjusted age below 40 years. After standardising the age structure, western provinces, including Tibet, Qinghai, Guizhou and Xinjiang, had the highest burden of ARDs. Males were disproportionately affected by ARDs. China’s overall age-standardised ARD burden has decreased since 1990, and females and eastern provinces experienced the largest decline. Regression results showed that the urban–rural gap in health workforce density was positively associated with the ARD burdens. CONCLUSION: Chronological age alone does not provide a strong enough basis for appropriate ageing resource planning or policymaking. In China, concerted efforts should be made to reduce the ARDs burden and its disparities. Health resources should be deliberately allocated to western provinces facing the greatest health challenges due to future ageing.
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spelling pubmed-96709592022-11-18 Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China Chen, Shu Si, Yafei Hanewald, Katja Li, Bingqin Bateman, Hazel Dai, Xiaochen Wu, Chenkai Tang, Shenglan BMJ Open Health Policy OBJECTIVES: To measure the disease burden of ageing based on age-related diseases (ARDs), the sex and regional disparities and the impact of health resources allocation on the burden in China. DESIGN: A national comparative study based on Global Burden of Diseases Study estimates and China’s routine official statistics. SETTING AND PARTICIPANTS: Thirty-one provinces of Mainland China were included for analysis in the study. No individuals were involved. METHODS: We first identified the ARDs and calculated the disability-adjusted life years (DALYs) of ARDs in 2016. We assessed the ARD burden disparities by province and sex and calculated the provincial ARD burden-adjusted age. We assessed historical changes between 1990 and 2016. Fixed effects regression models were adopted to evaluate the impact of health expenditures and health workforce indicators on the ARD burden in 2010–2016. RESULTS: In 2016, China’s total burden of ARDs was 15 703.7 DALYs (95% uncertainty intervals: 12 628.5, 18 406.2) per 100 000 population. Non-communicable diseases accounted for 91.9% of the burden. There were significant regional disparities. The leading five youngest provinces were Beijing, Guangdong, Shanghai, Zhejiang and Fujian, located on the east coast of China with an ARD burden-adjusted age below 40 years. After standardising the age structure, western provinces, including Tibet, Qinghai, Guizhou and Xinjiang, had the highest burden of ARDs. Males were disproportionately affected by ARDs. China’s overall age-standardised ARD burden has decreased since 1990, and females and eastern provinces experienced the largest decline. Regression results showed that the urban–rural gap in health workforce density was positively associated with the ARD burdens. CONCLUSION: Chronological age alone does not provide a strong enough basis for appropriate ageing resource planning or policymaking. In China, concerted efforts should be made to reduce the ARDs burden and its disparities. Health resources should be deliberately allocated to western provinces facing the greatest health challenges due to future ageing. BMJ Publishing Group 2022-11-15 /pmc/articles/PMC9670959/ /pubmed/36385040 http://dx.doi.org/10.1136/bmjopen-2022-064641 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Health Policy
Chen, Shu
Si, Yafei
Hanewald, Katja
Li, Bingqin
Bateman, Hazel
Dai, Xiaochen
Wu, Chenkai
Tang, Shenglan
Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China
title Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China
title_full Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China
title_fullStr Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China
title_full_unstemmed Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China
title_short Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China
title_sort disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in mainland china
topic Health Policy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670959/
https://www.ncbi.nlm.nih.gov/pubmed/36385040
http://dx.doi.org/10.1136/bmjopen-2022-064641
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