Global, regional and national time trends in incidence of adverse effects of medical treatment, 1990–2019: an age–period–cohort analysis from the Global Burden of Disease 2019 study

作者：Liangquan Lin · 发表于：BMJ Quality & Safety · 年份：2024 · DOI：10.1136/bmjqs-2023-016971 · 被引用次数：21 · 研究领域：Health Systems, Economic Evaluations, Quality of Life、Health Promotion and Cardiovascular Prevention、Healthcare cost, quality, practices

BACKGROUND: Current adverse effects of medical treatment (AEMT) incidence estimates rely on limited record reviews and underreporting surveillance systems. This study evaluated global and national longitudinal patterns in AEMT incidence from 1990 to 2019 using the Global Burden of Disease (GBD) framework. METHODS: AEMT was defined as harm resulting from a procedure, treatment or other contact with the healthcare system. The overall crude incidence rate, age-standardised incidence rate and their changes over time were analysed to evaluate temporal trends. Data were stratified by sociodemographic index (SDI) quintiles, age groups and sex to address heterogeneity across and within nations. An age-period-cohort model framework was used to differentiate the contributions of age, period and cohort effects on AEMT incidence changes. The model estimated overall and age-specific annual percentage changes in incidence rates. FINDINGS: Although the global population increased 44.6% from 1990 to 2019, AEMT incidents rose faster by 59.3%. The net drift in the global incidence rate was 0.631% per year. The proportion of all cases accounted for by older adults and the incidence rate among older adults increased globally. The high SDI region had much higher and increasing incidence rates versus declining rates in lower SDI regions. The age effects showed that in the high SDI region, the incidence rate is higher among older adults. Globally, the period effect showed a rising incidence of risk...