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.
ObjectiveTo analyze the epidemiological trends and current status of disease burden of type 2 diabetes related chronic kidney disease (CKD-T2D) in China from 1990 to 2021 and predict its future trends. MethodsThis study was based on the global burden of disease 2021 (GBD 2021) database to obtain the disease burden data of CKD-T2D in China, including the data of incidence, mortality and disability-adjusted life years (DALY), and used the Bayesian age-period-cohort (BAPC) model to predict the change trends until 2035. ResultsFrom 1990 to 2021, the standardized incidence rate of CKD-T2D in China showed an overall upward trend, while the standardized mortality rate and DALY rate showed an overall downward trend, with the average annual percentage change (AAPC) being 0.04%, ‒0.04%, ‒1.11% (P<0.05). Moreover, CKD-T2D in the whole country presented the characteristics of high incidence, high mortality and high DALY burden in the elderly population. From 2022 to 2035, all disease burden indicators of CKD-T2D in China are expected to show an overall downward trend. It is expected that the standardized incidence rate, mortality rate and DALY rate will drop to 16.21/100 000, 4.62/100 000 and 99.35/100 000 respectively in 2035. The overall decline of each indicator in the female population in China is greater than that in the male population. ConclusionThe prevention and treatment situation of CKD-T2D in China is severe, the burden caused by disability is relatively heavy and the burden of male and elderly populations is particularly heavy.
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.
ObjectiveTo understand the current status of research methods in disease burden systematic reviews, identify limitations and shortcomings of existing research methods, and provide suggestions to address relevant issues. MethodsA computer search of the PubMed database was conducted to collect systematic reviews on disease burden, with search limits set from database inception to December 21, 2023. Two independent researchers utilized Endnote 20 for literature screening and Excel 2019 for data extraction and descriptive analysis. ResultsA total of 216 articles were included in the review, revealing a year-on-year increase in the number of systematic reviews on disease burden since 2004. The journal PharmacoEconomics published the most articles (n=22), while research on certain infectious diseases and parasitic infections was the most prevalent (n=51). Only 31 articles provided a complete account of the entire systematic review process. The reporting rates for inclusion/exclusion criteria, information retrieval, literature screening, and statistical analysis steps were all 100%. However, the rate of protocol registration was relatively low at 19%. Eighty-eight percent of the articles utilized software such as Excel and Epidata for data extraction, yet only 32% adhered to the reproducibility principles outlined in AMSTAR-2. In terms of quality assessment, 105 articles underwent evaluation, with the Joanna Briggs Institute checklist and Newcastle-Ottawa scale being the most commonly used quality assessment tools for epidemiological studies, while economic studies preferred the Drummond checklist (n=9). Regarding the details of inclusion/exclusion criteria, only 53% of studies reported their study design in detail, and less than one-sixth provided a comprehensive description of the interventions and control measures. Statistical analyses predominantly employed qualitative methods (80%), with quantitative analyses comprising a minority (20%), all of which were conducted using meta-analysis techniques, primarily utilizing R software (n=15). ConclusionThe number of systematic reviews on disease burden has shown a yearly increasing trend; however, most studies have failed to comprehensively adhere to the fundamental processes of systematic reviews, significantly limiting their quality. Currently, the primary issues include a lack of protocol registration, incomplete supplementary searches, mismatched quality assessment tools, and insufficiently comprehensive outcome measures. To address these challenges, it is essential to develop a methodological guideline for systematic reviews on disease burden that incorporates these concerns. Such a guideline would standardize researchers' practices and ensure strict adherence to systematic review methodologies, thereby enhancing the scientific rigor of the research and its support for clinical decision-making.
ObjectivesTo systematically review the disease burden and epidemiological characteristics of tuberculosis in the Chinese population, and to provide reference for health resources allocation and health policy making.MethodsDatabases such as PubMed, EMbase, CNKI, VIP and WanFang Data were searched for studies investigating disease burden of tuberculosis in Chinese population from inception to August 1st, 2017. Two researchers independently screened literature, exacted data and assessed methodological quality of included studies. Statistical analysis was performed on data of tuberculosis associated population, mortality and disease burden.ResultsA total of 40 studies were included. The results of qualitative analysis showed that, since 1990, the prevalence of tuberculosis and its disease burden in China decreased year by year. However, the disease burden per patient and the total economic burden in China showed an increasing trend, and the economical disease burden increased 1.6 times from 1993 to 2003. The disease burden of men was higher than that of women, and it was higher in the countryside than in the city. In 2004, the ratio of YLL per thousand people in rural and urban areas was 2.18, and the ratio was 1.29 in 2014. Additionally, the disease burden decreased gradually in western, central and eastern regions. In 2014, compared with 2004, YLL decreased by 1.11, while the central and eastern regions were 0.48 and 0.25, respectively. The gap between the gender, the urban and rural areas and the regions was not as significant as in previous.ConclusionsThe disease burden of tuberculosis in China is seriously high and the tuberculosis prevention and control work should take into consideration the epidemiological characteristics of tuberculosis and the trends of the disease burden. It is necessary to rationally and effectively implement health intervention programs and allocate health resources based on different health demands in different regions and age groups to reduce the morbidity and mortality, and to pay more attention to drug-resistant tuberculosis. Besides, the emphasis of prevention should be placed on reducing disease burden in the elderly and strengthening prevention in the young population.
Objective To evaluate the disease burden of acne vulgaris in China from 1990 to 2019 and to provide references for the prevention and control of acne vulgaris in China. MethodsThe quantity of incidences/illnesses, age-standardized incidence/prevalence rates, disability-adjusted life years (DALYs), and DALY rate of acne vulgaris in China from 1990 to 2019 which were derived from the Global Burden of Disease (GBD) 2019 were evaluated. The epidemiological trends, age-birth-cohort trends, and the relationship between the incidence and sociodemographic index (SDI) were also analyzed. Results In 2019, the prevalence and incidence of acne vulgaris in China were higher than the global average. The quantity of patients was slightly higher in 2019 than that in 1990 (3.91%), and the prevalence, incidence, and DALY rate showed a continuous growth trend. The incidence of acne vulgaris peaked at 10 to 14 years old. Acne vulgaris mostly affected young males, and its prevalence peaked at approximately 15 to 19 years old. With these two age groups as the boundary, there was a trend of the prevalence of acne vulgaris increasing initially and then decreasing. Obvious gender differences existed for acne vulgaris diagnoses, and most of the above indicators were shown at a higher level in females than in males. The age period cohort analysis showed that the incidence rate of acne vulgaris in China from 1990 to 2019 was significantly different from the net drift, age effect, period effect and cohort effect. As the SDI value increased, the incidence of acne vulgaris showed a linear growth trend. Conclusions From 1990 to 2019, the burden of acne disease in China increases significantly.
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.
Objective To analyze the characteristic and temporal trend in mortality and disease burden of Alzheimer’s disease (AD) and other forms of dementia in Guangzhou from 2008 to 2019, and estimate the disease burden attributable to smoking to provide evidence for promoting local health policy of prevention and intervention of dementia. Methods Based on the data of Guangzhou surveillance point of the National Mortality Surveillance System (NMSS), the crude mortality, standardized mortality, years of life lost (YLL) of AD and other dementia were calculated. The indirect method was used to estimate years lived with disability (YLD) and disability-adjusted life years (DALY).The distribution and changing trends of the index rates were compared from 2008 to 2019 using Joinpoint Regression Program. Based on the data of Guangzhou Chronic Disease and Risk Factors Monitoring System in 2013, the indexes of disease burden of AD and other forms of dementia attributable to smoking in 2018 was calculated. Results The standardized mortality rate, YLL rate, YLD rate and DALY rate of AD and other forms of dementia in Guangzhou increased from 0.45/100 000, 0.05‰, 0.02‰ and 0.07 ‰ in 2008 to 1.28/100 000, 0.15‰, 0.07‰ and 0.22‰ in 2019, respectively. The average annual changing trend was statistically significant (AAPC=11.30%, 13.09%, 13.09%, 13.09%, P<0.001）. In most years, the mortality and disease burden of women were higher than those of men, but men had higher growing trend than women in standardized mortality rate, YLL rate, YLD rate and DALY rate from 2008 to 2019, with a slower growing speed after the year 2012.The disease burden of dementia attributable to smoking in men was significantly higher than that in women. Conclusion The mortality and disease burden of AD and other forms of dementia in Guangzhou have dramatically increased over the past twelve years. Intervention against modifiable factors such as smoking, and prevention and screening for dementia in key populations should be strengthened. Support policies for dementia care management should be adopted to reduce the disease burden caused by premature death and disability.
ObjectiveTo systematically review the disease burden of pneumoconiosis in Chinese population so as to provide references for health resources allocation and health policy making.MethodsDatabases including PubMed, EBSCO, Web of Science, CNKI, WanFang Data and VIP databases were searched for studies on investigation of the disease burden of pneumoconiosis in Chinese population from inception to 31st January, 2020. Two reviewers independently screened literature, exacted data, and assessed risk of bias of included studies. Systematic review was performed on data of pneumoconiosis associated population, mortality, and disease burden.ResultsA total of 26 studies were included. Qualitative analysis showed that the decrease of DALY and YLL of pneumoconiosis in China had been lower than that in globally, and the increase of YLD had been higher than that in globally in recent 10 years. 14 factors were included in the analysis of influencing factors on the financial burden or hospitalization expenses of pneumoconiosis patients; among them, the length of hospitalization, related complications, and pneumoconiosis stage were the most important indexes which had influence or difference on patients’ financial burden (or hospitalization expenses). The burden of pneumoconiosis in the Chinese population was primarily concentrated on males. Occupational diseases caused most of them, and middle-aged and older adults were the primary population for pneumoconiosis. However, young patients due to early-onset age, long course of disease and complications, and other factors resulting in a larger YLD phenomenon should also be considered.ConclusionsThe disease burden of pneumoconiosis patients in China is still heavy. It is recommended to continue to reduce the DALY of pneumoconiosis among the Chinese population as a long-term goal, and to strengthen control strategies to curb the early onset and death of pneumoconiosis.
ObjectiveTo analyze the disease burden of prostate, bladder and kidney cancers attributable to smoking in China from 1990 to 2019. MethodsBased on the global burden of disease study 2019, the current situation of the disease burden of prostate, bladder and kidney cancers attributable to smoking was analyzed by using the population attributable fraction (PAF), deaths and disability-adjusted life years (DALYs). Furthermore, the annual percent change (APC) and the average annual percent change (AAPC) were calculated by joinpoint regression analysis to describe the long-term trends of the smoking-attributable burden of these three cancers from 1990 to 2019. ResultsThere were an estimated 18 800 cases of deaths and 393 106 person-years of DALYs for bladder cancer caused by smoking in 2019. The age-standardized mortality and DALY rate decreased by 0.41% and 0.39% per year from 1990 to 2019, respectively. For prostate cancer, smoking was estimated to have caused 5 016 cases of deaths and 98 276 person-years of DALYs in 2019. The age-standardized mortality and DALY rate decreased by 0.28% and 0.25% per year from 1990 to 2019, respectively. For kidney cancer, the deaths and DALYs attributable to smoking were 4 935 cases and 120 620 person-years, respectively. The standardized mortality and DALY rates increased by 3.03% and 2.98% per year from 1990 to 2019. Additionally, males suffered from a higher disease burden of these three cancers attributable to smoking than females. The elderly population had a higher smoking-attributable disease burden than the younger population. ConclusionThe situation of the disease burden of bladder, prostate and kidney cancers attributable to smoking is still serious in China, which has substantial disparities in different groups. Specifically, males and the elderly are the high-risk groups for the smoking-attributable burden. Among the three cancers, bladder cancer has the highest burden and kidney cancer has the largest burden increase during 1990-2019.