The application scenarios and conditions of the burden of disease were sorted out, and the survey databases related to disease surveillance at home and abroad and the GBD research of IHME were introduced. Through the collection of literature, five cases of the burden of disease application of health big data were summarized, and their construction modes were described in detail based on different types of databases. We pointed out the problems and challenges faced by the application of health data, and put forward some ideas and prospects for future research on the application of the burden of disease of health big data.
ObjectiveTo analyze the trend of disease burden of colorectal cancer (CRC) in China from 1990 to 2019.MethodsData was obtained from Global Burden of Disease Study 2019 (GBD 2019). Incidence, mortality, disability-adjusted life year (DALY), years of life lost (YLL), years lived with disability (YLD), and their corresponding standardized rate and annual average percentage change (AAPC) were used to describe the changes of disease burden of colorectal cancer in Chinese population between 1990 and 2019.ResultsCompared with 1990, the number of new cases, standardized incidence, the number of deaths and standardized mortality of CRC in China in 2019 increased by 474.03%, 144.01%, 230.14%, and 36.15%, respectively. The standardized mortality and standardized incidence of CRC in China had reached and gradually exceeded the global level since 2010. From 1990 to 2019, the overall standard incidence (AAPC=3.6%, P<0.05), standard mortality rate (AAPC=1.4%, P<0.05), and the standard DALY rate (AAPC=1.2%, P<0.05) of CRC in China showed an increasing trend. The incidence, mortality and DALY rates of males were higher than those of females, and gradually increased with age. Compared with 1990, the DALY, YLL, and YLD of CRC in 2019 increased by 134.3%, 127.69%, and 445.00%, and their corresponding standardized rates increased by 30.53%, 27.03%, and 187.29%, respectively, showing an overall upward trend.ConclusionsFrom 1990 to 2019, the standardized incidence rate and standardized mortality rate of colorectal cancer in China have had a continuously increasing trend, and males and the elderly are high-risk groups. To reduce the burden of colorectal cancer in China, effective measures should be taken for prevention and management.
Objectives To investigate the personnel allocation and workloads of the medical residents across the subspecialties of the Department of Internal Medicine at a tertiary hospital. Methods A cross-sectional survey was performed to investigate personnel allocation and workload. The resulting data were compared with the ministerial standard that regulates the training of medical residents. Results Aside from the subspecialty of Rheumatology, medical residents accounted for 40% to 70% of the total staff physicians. The faculty physicians accounted for only 20% to 50% of the total. When the non-faculty residents were not taken into account, each individual faculty physician took charge of between 5.3 to 15.5 beds across all the subspecialties. When only the non-faculty residents were accounted for, each individual resident took charge of 1.7 to 9.4 beds, 1.3 to 5.7 bed-days per day, and 5.8 to 17.3 patients per month. When both were accounted for, each physician was responsible for 1.3 to 5.9 beds, 1 to 3.6 bed-days per day, and 4.2 to 10.7 patients per month. In comparison with the ministerial standards, medical residents have managed more patients per month in the subspecialties of Nephrology, Respiratory Diseases, Digestive Diseases, Neurology and Infection.Fewer patients were managed in the subspecialty of Endocrinology. Conclusion The medical resident allocation is balanced across the subspecialties of the Department of Internal Medicine, although it is less stable. The total number of physicians is smaller than required, and physicians generally bear an overload of work. The number of patients managed by each individual resident is more than the requirement set by the ministerial standards, and has significant variations across subspecialties. Medical residents need to be allocated in accordance with the corresponding workloads.
Objective To investigate inpatients disease constitution, costs and rational drug use in the Karamay Central Hospital in 2014 and provide baseline data for further evidence-based study. Methods The information of disease classification, single disease drug use and expenditure of inpatients in 2014 were collected from the Hospital Information System (HIS) of Karamay Central Hospital. We classified the diseases according to the international classification of diseases coding (ICD-10), and analyzed the data by Microsoft Excel 2007 software including frequency, proportion, cumulative proportion and sample average. Results ① A total of 24 936 inpatients in 2014 were included, with male to female ratio being 0.96 to 1 and minority rate being 22.95%. The top three systematic diseases were respiratory diseases, diseases concerning pregnancy, child birth and puerperium and circulatory system diseases respectively; ② The top three age groups were 25 to 59, ≥60 and 0 to 4 respectively; ③ The top three costs per capita of single disease were pulmonary infectious, tumor chemotherapy and symptomatic treatment respectively; the top three western medicine costs per capita were tumor chemotherapy, symptomatic treatment and pulmonary infection; the top three Chinese medicine costs per capita were chronic kidney disease (CKD), angina and ischemic stroke. Conclusion The single diseases ranking and percentage of inpatients in 2014 of Karamay Central Hospital were different from the disease burden of Xinjiang Uygur Autonomous Region, the country and even the whole world. Based on the above results, the respiratory diseases and circulatory diseases were selected as the systematic evidence-based pharmacy study goal.
ObjectiveTo explore the effects of drug management skill training on lightening the family burden of schizophrenic patients in their recovery period. MethodsBetween December 2011 and December 2013, 101 patients with schizophrenia were randomly divided into experimental group (n=56) and control group (n=45). The experimental group was given drug management skill training, while the control group only received routine follow-up. The course of the research was six months. Both groups were assessed by the positive and negative syndrome scale on patients' psychological symptoms, and family burden scale of diseases was used to assess the burden of the family. ResultsCompared with the controls, patients in the experimental group improved more in their positive symptoms (t=2.692, P=0.008), negative symptoms (t=2.729, P=0.008), general psychopathology symptoms (t=3.231, P=0.002) and the whole psychiatric symptoms (t=3.870, P<0.001). Moreover, the degree of patients' symptom improvement was positively correlated with the degree of family burden lightening (r=0.44, P<0.001). ConclusionFor patients with schizophrenia, reasonable drug management skill training can effectively improve patients' medication compliance, promote treatment effect and lighten family burden.
ObjectiveTo propose policy recommendations for improvement of the affordability of high cost medicines with significant public health implications under the patent system in China. MethodsThrough literature analysis and market investigation, this study targeted expensive life saving medicines under the patent protection, which are critical for the treatment of eight diseases with the most significant disease burden and critical social, economic and political impact for case studies, estimated the individual and insurance direct economic burden of medicines treatment. ResultsChemical product patent protection enhanced medicines price monopoly. The targeted medicines brought huge financial burden to Chinese citizens, especially to the rural residents. Breaking chemical product patent protection, achieving parallel importation or making generic drugs enter into the China's market, can save huge amount of medicines procurement budget for the government, and benefit the general public. ConclusionDeveloping and implementing medicines registration and intellectual property right protection strategies with public health perspective, adding continuously improved basic health insurance programs, can effectively promote the affordability of high cost medicines with significant public health, social, political and economic implications.
ObjectiveTo analyze the epidemiological burden and trend of skin malignant melanoma in China based on the data from the global burden of disease 2019 (GBD 2019). MethodsThe data about quantity of incidences/illnesses/deaths, age-standardized incidence/prevalence rates/mortality, disability-adjusted life years (DALYs), and DALY rate of skin malignant melanoma in China from 1990 to 2019 were obtained from the GBD 2019 databases. The epidemiological trends, age-period-cohort trends, and the relationship between the incidence and sociodemographic index (SDI) were analyzed.ResultsIn 2019, both prevalence and incidence of skin malignant melanoma in China were at low levels in the world, the age-standardized mortality ranked the 35th in the 204 countries GBD researched, the number of prevalent cases and incident cases increased compared with 1990 (12.65% and 3.57%, respectively), the prevalence and incidence rates showed growth trends, while the DALY rate and mortality decreased slowly. The prevalence of skin malignant melanoma peaked age at 50 to 54 years old. The incidence peak age of males was older than that of females (55-59 years old for males vs. 50-54 years old for females), while the mortality peak age of males was younger than that of females (55-59 years old for males vs. 75-79 years old for females). With the increasing of SDI value, the incidence of skin malignant melanoma showed a linear growth trend. DALY rate was negatively correlated with SDI (P<0.05). ConclusionFrom 1990 to 2019, age-standardized incidence and prevalence of skin malignant melanoma in China are increasing, while DALY rate and mortality are decreasing, and these are correlated with social and medical development.
ObjectivesTo estimate the latest burden of disability adjusted life years (DALYs) for liver cancer in China and the long-term trend, and to make future prediction.MethodsBased on the visualization platform of Global Burden of Disease 2016, data on the DALYs for liver cancer in China was extracted. The very recent status in 2016 and the previous trend from 1990 to 2016 were described, using annualized rate of change (ARC). The burden from 2017 to 2050 was further predicted by combining the ARC and the Chinese population data projected by the United Nation.ResultsIn 2016, the total DALYs for liver cancer in China was estimated as 11 539 000 person years (accounting for 54.6% of the global burden), and years of life lost (YLLs) and years lived with disability (YLDs) contributed 98.9% and 1.1%, respectively. The age-standardized DALY rate was 844.1 per 100 000 (3.0 times of the global average) and the male-to-female ratio was 3.4. The DALY rate continuously increased from 1990–2016 (ARC=0.57%), particularly in recent 5 years (ARC=1.75%). Among the DALYs for all cancers, liver cancer contributed approximately 20% and constantly remained as the top 2 (ranking as the number one before year 2005). There were inverse trends in gender, with increasing in males and decreasing in females (ARC was 0.77% and –0.11%, respectively). Hepatitis B infection continually kept the leading cause of DALYs for liver cancer (accounting for nearly 57%), and the DALY rate was gradually increasing (ARC=0.43%). Although the peak age of DALY rate was stable at 65to 69 years, the peak age of the DALYs changed from 55 to 59 years in 1990 to 60 ~ 64 years in 2016. In 2050, the estimated DALYs for liver cancer in China will reach 14.37 million person years, 20.0% more than that in 2017.ConclusionsThe DALYs caused by liver cancer in China exceeds the overall burden of all other countries in the world, and accounts for 1/5 of DALYs for all cancers in local population. The burden in males has been continuously rising, and the leading cause remained unchanged as hepatitis B infection. With population aging, the DALYs for liver cancer in China will be incessant to increase, suggesting the necessity to implement continuous effort in risk factors prevention (e.g. hepatitis B infection), and efficient management in high risk population of liver cancer.
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.
ObjectiveTo analyze the variation trend of high low density lipoprotein cholesterol (LDL-C) attribution disease burden in China from 1990 to 2019. MethodsThe burden of disease indicators from Global Burden of Disease 2019 (GBD 2019), such as death attributable to high LDL-C, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lost to disability (YLDs) were extracted. The age was standardized using GBD 2019 global standard population, and the trend of rates with the annual percentage change (APC) was analyzed. ResultsFrom 1990 to 2019, the disease burden of high LDL-C increased with age in China. The mortality rate, DALYs rate and YLLs rate of males were higher than those of females, while the YLDs rate of males was lower than that of females. Joinpoint regression results showed that from 1990 to 2019, the high LDL-C attribution mortality rate (APC=3.4%, P<0.05), DALYs rate (APC=2.4%, P<0.05), YLLs rate (APC=2.4%, P<0.05), YLDs rate (APC = 2.9%, P<0.05), the standardized mortality rate (APC=0.8%, P<0.05) and the standardized YLDs rate (APC=0.7%, P<0.05) all increased in China. Regarding age, the mortality rate, DALYs rate and YLLs rate increased in the age group over 70 years old, while the YLDs rate increased significantly in the age group over 45 years old. ConclusionFrom 1990 to 2019, the burden of disease attributable to high LDL-C in China has become increasingly heavy, and the burden varies according to gender and age.