Abstract
AbstractIntroductionBuilding on past frameworks, our aim was to systematically analyze the healthcare access and quality (HAQ) index for surgically treatable conditions, its progress over time, and the gap compared to non-surgical HAQ across 204 countries and territories from 1990 to 2019.MethodsData was obtained from the Global Burden of Disease 2019 study. Of the 32 conditions with preventable mortality included in the HAQ index, 14 were considered surgically treatable following an existing framework. We used mortality-to-incidence ratios and risk-standardized death rates. An easily interpretable, computable, and partially compensatory composite index ranging from 0 (worst) to 100 (best) was constructed using the adjusted Mazziotta Pareto index methodology. The indicators were scaled by min-max scaling, aggregated using arithmetic mean, and the aggregate was penalized for imbalance using a variance term. Similarly, a non-surgical HAQ index was calculated, including the 18 remaining conditions. To track progress over time, relative change was calculated as the ratio of surgical HAQ in 2019 to that in 1990. Further, the relative gap in 2019 was calculated as the surgical-to-non-surgical HAQ ratio. Ratio values >1 depicted improvement over time or better performing surgical systems.ResultsIn 2019, surgical HAQ varied from 18.00 for the Central African Republic to 98.25 for Canada. The surgical HAQ showed the greatest relative change for Ethiopia (2019:1990 ratio=3.88), while Zimbabwe saw a slight worsening (ratio=0.92). In 2019, Mauritius had the largest surgical-to-non-surgical HAQ ratio of 1.16, while the surgical HAQ lagged behind its non-surgical HAQ for the Central African Republic (ratio=0.44).ConclusionThe presented index and comprehensive global analysis are valuable for global assessments, policymaking, and advocacy for investing in surgical systems.
Publisher
Cold Spring Harbor Laboratory