目的了解新疆生产建设兵团(简称兵团)肿瘤登记地区恶性肿瘤死亡情况及疾病负担,为肿瘤防治提供依据。方法收集2010年兵团肿瘤登记地区(第七师、第八师)恶性肿瘤发病资料和死亡资料,利用死亡率(mortality)、潜在减寿年(potential years o...目的了解新疆生产建设兵团(简称兵团)肿瘤登记地区恶性肿瘤死亡情况及疾病负担,为肿瘤防治提供依据。方法收集2010年兵团肿瘤登记地区(第七师、第八师)恶性肿瘤发病资料和死亡资料,利用死亡率(mortality)、潜在减寿年(potential years of life lost,PYLL)、伤残调整生命年(disability adjusted life year,DALY)包括早死所致的健康寿命损失年(years of life lost,YLL)和残疾所致的健康寿命损失年(years lived with disability,Y L D)评价恶性肿瘤疾病负担。结果2010年肿瘤登记地区全部恶性肿瘤死亡率为113.36/10万,中标率、世标率分别为58.50/10万、79.05/10万。男性死亡率139.08/10万高于女性死亡率87.13/10万。全部肿瘤PYLL为11 603.5人年,PYLL率为10.05‰,高于兵团2008—2012年死因分析恶性肿瘤平均水平。全部肿瘤DALYs率为13.14/千人、YLDs和YLLs分别为0.83/千人和12.31/千人;男性YLLs为13.50/千人高于女性YLLs 10.88/千人。PYLL率与DALYs率随年龄增加而上升,其中PYLL和PYLL率在40岁之后达到高峰,DALYs率从40岁年龄组开始明显升高,在60~69岁年龄组达到最高,且从65岁开始男性高于女性。2010年女性DALYs/千人高于全国水平。结论兵团肿瘤登记地区肿瘤疾病负担较重,男性高于女性,中老年人肿瘤疾病负担最高,应加强肿瘤的早诊早治项目,减轻居民肿瘤疾病负担。展开更多
Objective The study investigated the burden of smear-positive pulmonary TB and itsinfectivity using DALY(disability-adjusted life year) as an indicator. Methods An assumedcohort of 2 000 cases was set up based ...Objective The study investigated the burden of smear-positive pulmonary TB and itsinfectivity using DALY(disability-adjusted life year) as an indicator. Methods An assumedcohort of 2 000 cases was set up based on the age-specific incidence of 794 newly registeredsmear-positive cases in Beijing in 1994. Prognostic trees and model diagrams of infectivityunder natural history and DOTS(directly observed treatment, short-course) strategy wereestablished according to the epidemiological evidence. Results The results showed that 29. 6%of DALYs would be neglected if the burden caused by the infectivity was not considered.Conclusion DOTS strategy may reduce 97.3% of the number of potential cases infected,92.9% of DALYs related to TB-patients themselves, and 99.9% of DALYs caused by TB’sinfectivity as well.展开更多
<strong>Background:</strong> In Greece, the provision of mental health services is limited to people residing in rural and remote areas. The operation of Mobile Mental Health Units (MMHUs) has been introdu...<strong>Background:</strong> In Greece, the provision of mental health services is limited to people residing in rural and remote areas. The operation of Mobile Mental Health Units (MMHUs) has been introduced in the Cyclades islands. It is an innovative policy intervention that has been shown to be effective and efficient internationally. <strong>Objective:</strong> The aim was to evaluate the operation of MMHUs in the Cyclades islands based on real-world evidence (RWE), from a societal perspective. <strong>Methods: </strong>A cost-effectiveness analysis was performed where outcomes and costs were elaborated and classified based on two comparators, 1) with MMHUs’ operation and 2) without MMHUs’ operation. Clinical primary outcomes were based on RWE data and were elaborated for the Disability-Adjusted Life Years (DALYs) values calculation, for a 12 months’ time horizon. Data descriptive statistics were performed with SPSS Statistics 22.0. Direct medical, non-medical and indirect costs were incorporated. Unit costs and monetary values were extracted from published data. Sensitivity analysis was undertaken to test the robustness of the results. <strong>Results:</strong> The operation of MMHUs in the Cyclades islands led to an incremental cost of €12,250.78 per DALY averted. A substantial higher increase is observed in the direct non-medical costs of the non-MMHUs’ operation where patients had to pay approximately €2,602 per capita annually for their transportation and accommodation due to hospitalization and outpatient care. Informal care expenses are 3 fold increasing in the non-MMHUs’ operation arm. Both direct non-medical and informal care costs correspond to high out of pocket payments totally covered by the patients. The sensitivity analyses demonstrated that the decision does not change when we varied the unit costs by ±10%. <strong>Conclusions:</strong> The operation of MMHUs appears to be a cost-effective option for treating patients with mental disorders in remote areas and islands in Greece. MMHUs appear to overcome the existing NHS structural inefficiencies by minimizing public expenditures and patients’ income losses by preventing and improving their mental health status.展开更多
Background:Atherosclerosis-related diseases represent significant health issues among adults globally.Despite their widespread impact,comprehensive data concerning the global and national burden and trends of these di...Background:Atherosclerosis-related diseases represent significant health issues among adults globally.Despite their widespread impact,comprehensive data concerning the global and national burden and trends of these diseases remain sparse.Our objective is to examine the trends in the burden of atherosclerosis among adults from 1990 to 2019 at both global and national levels.Methods:We reported the average annual percentage changes(AAPCs)in prevalence,incidence,mortality,and disabilityadjusted life years(DALYs)of atherosclerosis-related diseases(ischemic heart disease[IHD],ischemic stroke,and peripheral arterial disease[PAD])at the global and national levels among individuals based on a trend analysis of the Global Burden of Diseases Study(GBD)2019.We further analyzed these global trends as a function of age,gender,and the social development index.We also used joinpoint regression analysis to identify the year with the most substantial changes in global trends.Results:Globally,the AAPC of IHD incidence rose from 1990 to 2019(0.20;95%confidence interval[CI],0.12-0.28),with substantial surges in 1995,2001,2005,2010,and 2017.Conversely,AAPC of IHD mortality rates exhibited a different trend until a rise in 2014.The AAPC of incidence rates of ischemic stroke and PAD also escalated during the same period,with respective 0.43(95%CI,0.39-0.48)and 0.13(95%CI,0.06-0.21).For ischemic stroke,both incidence and mortality soared in 2014,while PAD incidence declined in 1994 and 1998,then sharply climbed in 2016.Nationally,the Northern Mariana Islands experienced the steepest increase in IHD and PAD incidence and mortality between 1990 and 2019.China saw a significant rise in ischemic stroke incidence,whereas the highest mortality rate increase occurred in Timor-Leste.By sociodemographic index(SDI)quintile,low-middle-,middle-,and high-middle-SDI countries all showed upward trends in IHD,ischemic stroke,and PAD incidence.Simultaneously,IHD and ischemic stroke mortality rates,as well as DALYs,dropped in the low-,high-middle-,and high-SDI nations.However,PAD mortality rates and DALYs saw an uptick across all SDI quintiles.Regarding age demographics,a global decrease in the AAPC IHD incidence as noted in individuals above 55 years old,in contrast to an increase in the 20-55 age group during this period.AAPC of mortality rates for IHD,ischemic stroke,and PAD decreased across all ages.The AAPC showed an increase in IHD incidence in both genders.Conversely,IHD’s DALYs saw a reduction in both males and females.Ischemic stroke patterns mirrored these trends,whereas all measures for PAD exhibited growth for both sexes.Conclusions:From 1990 to 2019,there was an overall increasing trend in the global incidence of all three clinical manifestations of atherosclerosis.Between 1990 and 2019,both the mortality rate and DALYs for IHD and ischemic stroke declined across all age groups.Overall,the burden of atherosclerosis-related diseases has not significantly decreased and even shows signs of trending upward.These findings strongly suggest that despite some progress made,efforts to control atherosclerosis diseases globally need to be intensified.展开更多
目的 2013年云南省死因监测系统数据分析显示,恶性肿瘤是导致云南省居民死亡的主要原因,并已成为严重威胁云南省居民健康的重大公共卫生问题。为了解云南省大理州居民恶性肿瘤死亡流行病学特征及寿命损失情况,根据2014年云南省死因监测...目的 2013年云南省死因监测系统数据分析显示,恶性肿瘤是导致云南省居民死亡的主要原因,并已成为严重威胁云南省居民健康的重大公共卫生问题。为了解云南省大理州居民恶性肿瘤死亡流行病学特征及寿命损失情况,根据2014年云南省死因监测系统资料,应用死亡率及潜在减寿年数等对大理州居民的肿瘤死亡情况进行分析,为制定恶性肿瘤防制工作措施提供依据。方法利用死因监测系统收集大理州居民2014年恶性肿瘤发病及死亡数据,分析恶性肿瘤的流行病学特征。采用Excel 2007计算2014年大理州各类恶性肿瘤的粗死亡率、标化死亡率、潜在减寿年数(potential years of life lost,PYLL)、减寿率(potential years of life lost rate,PYLLR)和平均减寿年数(average years of life lost,AYLL)等,以不同性别、不同年龄进行分层分析。结果2014年大理州恶性肿瘤死亡人数2 848例,死亡率为80.00/10万,标化死亡率为82.43/10万,占全死因构成比的13.61%。恶性肿瘤死亡率男性显著高于女性,且随年龄增长呈上升趋势。发病前5位依次为肺癌、肝癌、胃癌、肠癌、食道癌。恶性肿瘤死亡造成居民PYLL为41 021人年,PYLLR为11.52‰,AYLL为14.40年,其中肝癌的潜在减寿年数最高。结论大理州恶性肿瘤呈高发状态,其中肺癌,及以肝癌、胃癌、肠癌、食道癌为主的消化道肿瘤是严重危害当地居民健康最主要的恶性肿瘤,应作为防治重点。展开更多
文摘目的了解新疆生产建设兵团(简称兵团)肿瘤登记地区恶性肿瘤死亡情况及疾病负担,为肿瘤防治提供依据。方法收集2010年兵团肿瘤登记地区(第七师、第八师)恶性肿瘤发病资料和死亡资料,利用死亡率(mortality)、潜在减寿年(potential years of life lost,PYLL)、伤残调整生命年(disability adjusted life year,DALY)包括早死所致的健康寿命损失年(years of life lost,YLL)和残疾所致的健康寿命损失年(years lived with disability,Y L D)评价恶性肿瘤疾病负担。结果2010年肿瘤登记地区全部恶性肿瘤死亡率为113.36/10万,中标率、世标率分别为58.50/10万、79.05/10万。男性死亡率139.08/10万高于女性死亡率87.13/10万。全部肿瘤PYLL为11 603.5人年,PYLL率为10.05‰,高于兵团2008—2012年死因分析恶性肿瘤平均水平。全部肿瘤DALYs率为13.14/千人、YLDs和YLLs分别为0.83/千人和12.31/千人;男性YLLs为13.50/千人高于女性YLLs 10.88/千人。PYLL率与DALYs率随年龄增加而上升,其中PYLL和PYLL率在40岁之后达到高峰,DALYs率从40岁年龄组开始明显升高,在60~69岁年龄组达到最高,且从65岁开始男性高于女性。2010年女性DALYs/千人高于全国水平。结论兵团肿瘤登记地区肿瘤疾病负担较重,男性高于女性,中老年人肿瘤疾病负担最高,应加强肿瘤的早诊早治项目,减轻居民肿瘤疾病负担。
文摘Objective The study investigated the burden of smear-positive pulmonary TB and itsinfectivity using DALY(disability-adjusted life year) as an indicator. Methods An assumedcohort of 2 000 cases was set up based on the age-specific incidence of 794 newly registeredsmear-positive cases in Beijing in 1994. Prognostic trees and model diagrams of infectivityunder natural history and DOTS(directly observed treatment, short-course) strategy wereestablished according to the epidemiological evidence. Results The results showed that 29. 6%of DALYs would be neglected if the burden caused by the infectivity was not considered.Conclusion DOTS strategy may reduce 97.3% of the number of potential cases infected,92.9% of DALYs related to TB-patients themselves, and 99.9% of DALYs caused by TB’sinfectivity as well.
文摘<strong>Background:</strong> In Greece, the provision of mental health services is limited to people residing in rural and remote areas. The operation of Mobile Mental Health Units (MMHUs) has been introduced in the Cyclades islands. It is an innovative policy intervention that has been shown to be effective and efficient internationally. <strong>Objective:</strong> The aim was to evaluate the operation of MMHUs in the Cyclades islands based on real-world evidence (RWE), from a societal perspective. <strong>Methods: </strong>A cost-effectiveness analysis was performed where outcomes and costs were elaborated and classified based on two comparators, 1) with MMHUs’ operation and 2) without MMHUs’ operation. Clinical primary outcomes were based on RWE data and were elaborated for the Disability-Adjusted Life Years (DALYs) values calculation, for a 12 months’ time horizon. Data descriptive statistics were performed with SPSS Statistics 22.0. Direct medical, non-medical and indirect costs were incorporated. Unit costs and monetary values were extracted from published data. Sensitivity analysis was undertaken to test the robustness of the results. <strong>Results:</strong> The operation of MMHUs in the Cyclades islands led to an incremental cost of €12,250.78 per DALY averted. A substantial higher increase is observed in the direct non-medical costs of the non-MMHUs’ operation where patients had to pay approximately €2,602 per capita annually for their transportation and accommodation due to hospitalization and outpatient care. Informal care expenses are 3 fold increasing in the non-MMHUs’ operation arm. Both direct non-medical and informal care costs correspond to high out of pocket payments totally covered by the patients. The sensitivity analyses demonstrated that the decision does not change when we varied the unit costs by ±10%. <strong>Conclusions:</strong> The operation of MMHUs appears to be a cost-effective option for treating patients with mental disorders in remote areas and islands in Greece. MMHUs appear to overcome the existing NHS structural inefficiencies by minimizing public expenditures and patients’ income losses by preventing and improving their mental health status.
基金supported by grants from the Summit Talent Plan,Beijing Hospital Management Center(No.DFL20190101,Beijing,China).
文摘Background:Atherosclerosis-related diseases represent significant health issues among adults globally.Despite their widespread impact,comprehensive data concerning the global and national burden and trends of these diseases remain sparse.Our objective is to examine the trends in the burden of atherosclerosis among adults from 1990 to 2019 at both global and national levels.Methods:We reported the average annual percentage changes(AAPCs)in prevalence,incidence,mortality,and disabilityadjusted life years(DALYs)of atherosclerosis-related diseases(ischemic heart disease[IHD],ischemic stroke,and peripheral arterial disease[PAD])at the global and national levels among individuals based on a trend analysis of the Global Burden of Diseases Study(GBD)2019.We further analyzed these global trends as a function of age,gender,and the social development index.We also used joinpoint regression analysis to identify the year with the most substantial changes in global trends.Results:Globally,the AAPC of IHD incidence rose from 1990 to 2019(0.20;95%confidence interval[CI],0.12-0.28),with substantial surges in 1995,2001,2005,2010,and 2017.Conversely,AAPC of IHD mortality rates exhibited a different trend until a rise in 2014.The AAPC of incidence rates of ischemic stroke and PAD also escalated during the same period,with respective 0.43(95%CI,0.39-0.48)and 0.13(95%CI,0.06-0.21).For ischemic stroke,both incidence and mortality soared in 2014,while PAD incidence declined in 1994 and 1998,then sharply climbed in 2016.Nationally,the Northern Mariana Islands experienced the steepest increase in IHD and PAD incidence and mortality between 1990 and 2019.China saw a significant rise in ischemic stroke incidence,whereas the highest mortality rate increase occurred in Timor-Leste.By sociodemographic index(SDI)quintile,low-middle-,middle-,and high-middle-SDI countries all showed upward trends in IHD,ischemic stroke,and PAD incidence.Simultaneously,IHD and ischemic stroke mortality rates,as well as DALYs,dropped in the low-,high-middle-,and high-SDI nations.However,PAD mortality rates and DALYs saw an uptick across all SDI quintiles.Regarding age demographics,a global decrease in the AAPC IHD incidence as noted in individuals above 55 years old,in contrast to an increase in the 20-55 age group during this period.AAPC of mortality rates for IHD,ischemic stroke,and PAD decreased across all ages.The AAPC showed an increase in IHD incidence in both genders.Conversely,IHD’s DALYs saw a reduction in both males and females.Ischemic stroke patterns mirrored these trends,whereas all measures for PAD exhibited growth for both sexes.Conclusions:From 1990 to 2019,there was an overall increasing trend in the global incidence of all three clinical manifestations of atherosclerosis.Between 1990 and 2019,both the mortality rate and DALYs for IHD and ischemic stroke declined across all age groups.Overall,the burden of atherosclerosis-related diseases has not significantly decreased and even shows signs of trending upward.These findings strongly suggest that despite some progress made,efforts to control atherosclerosis diseases globally need to be intensified.
文摘目的 2013年云南省死因监测系统数据分析显示,恶性肿瘤是导致云南省居民死亡的主要原因,并已成为严重威胁云南省居民健康的重大公共卫生问题。为了解云南省大理州居民恶性肿瘤死亡流行病学特征及寿命损失情况,根据2014年云南省死因监测系统资料,应用死亡率及潜在减寿年数等对大理州居民的肿瘤死亡情况进行分析,为制定恶性肿瘤防制工作措施提供依据。方法利用死因监测系统收集大理州居民2014年恶性肿瘤发病及死亡数据,分析恶性肿瘤的流行病学特征。采用Excel 2007计算2014年大理州各类恶性肿瘤的粗死亡率、标化死亡率、潜在减寿年数(potential years of life lost,PYLL)、减寿率(potential years of life lost rate,PYLLR)和平均减寿年数(average years of life lost,AYLL)等,以不同性别、不同年龄进行分层分析。结果2014年大理州恶性肿瘤死亡人数2 848例,死亡率为80.00/10万,标化死亡率为82.43/10万,占全死因构成比的13.61%。恶性肿瘤死亡率男性显著高于女性,且随年龄增长呈上升趋势。发病前5位依次为肺癌、肝癌、胃癌、肠癌、食道癌。恶性肿瘤死亡造成居民PYLL为41 021人年,PYLLR为11.52‰,AYLL为14.40年,其中肝癌的潜在减寿年数最高。结论大理州恶性肿瘤呈高发状态,其中肺癌,及以肝癌、胃癌、肠癌、食道癌为主的消化道肿瘤是严重危害当地居民健康最主要的恶性肿瘤,应作为防治重点。
