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. 2022 Aug 1;17(8):e0271284.
doi: 10.1371/journal.pone.0271284. eCollection 2022.

Quality of care of peptic ulcer disease worldwide: A systematic analysis for the global burden of disease study 1990-2019

Mohsen Abbasi-Kangevari  1 , Naser Ahmadi  1 , Nima Fattahi  1 , Negar Rezaei  1   2 , Mohammad-Reza Malekpour  1 , Seyyed-Hadi Ghamari  1 , Sahar Saeedi Moghaddam  1 , Sina Azadnajafabad  1 , Zahra Esfahani  1   3 , Ali-Asghar Kolahi  4 , Shahin Roshani  1   5 , Sahba Rezazadeh-Khadem  1 , Fateme Gorgani  1 , Seyyed Nima Naleini  6 , Shohreh Naderimagham  1   7 , Bagher Larijani  2 , Farshad Farzadfar  1   2
Affiliations

Quality of care of peptic ulcer disease worldwide: A systematic analysis for the global burden of disease study 1990-2019

Mohsen Abbasi-Kangevari et al. PLoS One. .

Abstract

Background: Peptic ulcer disease (PUD) affects four million people worldwide annually and has an estimated lifetime prevalence of 5-10% in the general population. Worldwide, there are significant heterogeneities in coping approaches of healthcare systems with PUD in prevention, diagnosis, treatment, and follow-up. Quantifying and benchmarking health systems' performance is crucial yet challenging to provide a clearer picture of the potential global inequities in the quality of care.

Objective: The objective of this study was to compare the health-system quality-of-care and inequities for PUD among age groups and sexes worldwide.

Methods: Data were derived from the Global Burden of Disease Study 1990-2019. Principal-Component-Analysis was used to combine age-standardized mortality-to-incidence-ratio, disability-adjusted-life-years-to-prevalence-ratio, prevalence-to-incidence-ratio, and years-of-life-lost-to-years-lived-with-disability-into a single proxy named Quality-of-Care-Index (QCI). QCI was used to compare the quality of care among countries. QCI's validity was investigated via correlation with the cause-specific Healthcare-Access-and-Quality-index, which was acceptable. Inequities were presented among age groups and sexes. Gender Disparity Ratio was obtained by dividing the score of women by that of men.

Results: Global QCI was 72.6 in 1990, which increased by 14.6% to 83.2 in 2019. High-income-Asia-pacific had the highest QCI, while Central Latin America had the lowest. QCI of high-SDI countries was 82.9 in 1990, which increased to 92.9 in 2019. The QCI of low-SDI countries was 65.0 in 1990, which increased to 76.9 in 2019. There was heterogeneity among the QCI-level of countries with the same SDI level. QCI typically decreased as people aged; however, this gap was more significant among low-SDI countries. The global Gender Disparity Ratio was close to one and ranged from 0.97 to 1.03 in 100 of 204 countries.

Conclusion: QCI of PUD improved dramatically during 1990-2019 worldwide. There are still significant heterogeneities among countries on different and similar SDI levels.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Quality of care index for peptic ulcer disease by country in 1990 and 2019.
Fig 2
Fig 2. Quality of care index for peptic ulcer disease by SDI score of countries in 2019.
Fig 3
Fig 3. Age pattern for quality of care index based on SDI in 1990 and 2019.
Fig 4
Fig 4. Gender disparity ratio for quality of care index of peptic ulcer disease among age groups and SDI levels in 1990 and 2019.
See this image and copyright information in PMC

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Grants and funding

The author(s) received no specific funding for this work.