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Physical Rehabilitation Needs Per Condition Type: Results From the Global Burden of Disease Study 2017

  • Tiago S. Jesus
    Correspondence
    Corresponding author Tiago S. Jesus, PhD, Global Health and Tropical Medicine and WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon, Rua da Junqueira 100, Lisbon 1349-008, Portugal.
    Affiliations
    Global Health and Tropical Medicine and WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon, Lisbon, Portugal
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  • Michel D. Landry
    Affiliations
    School of Medicine, Duke University, Durham, NC

    Duke Global Health Institute, Duke University, Durham, NC
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  • Dina Brooks
    Affiliations
    School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada

    West Park Health Care Centre, Toronto, Ontario, Canada
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  • Helen Hoenig
    Affiliations
    Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC

    Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC
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Published:February 05, 2020DOI:https://doi.org/10.1016/j.apmr.2019.12.020

      Abstract

      Objective

      To determine how total physical rehabilitation needs have been distributed per relevant condition groups (musculoskeletal and pain, neurologic cardiothoracic, neoplasms, pediatric, human immunodeficiency virus [HIV] related), globally and across countries of varying income level.

      Design

      Subgroup, secondary analyses of data from the Global Burden of Disease 2017. Data for the year 2017 are used for determining current needs and data from every year between 1990 and 2017 for determining changing trends.

      Settings

      Globally and high-, upper-middle-, lower-middle-, and low-income countries.

      Participants

      Not applicable.

      Interventions

      Not applicable.

      Main Outcome Measure

      Years lived with disability (YLD) rates per 100,000 people for the 6 condition groups.

      Results

      In 2017, musculoskeletal and pain conditions accounted for 52.6% of the total physical rehabilitation needs worldwide, :HIV related for 5.7% of the physical rehabilitation needs in low-income nations, but about 1% in all other locations. Worldwide, significant increases in YLD rates were observed since 1990 for the 6 condition groups (P<.01). However, across country types, we observed significant decreases in YLD rates for specific conditions: pediatric in high-income countries, and neurologic and neoplasm conditions in low-income countries (P<.01). In upper-middle-income countries, YLD rates from neurologic and neoplasm conditions grew exponentially since 1990, with overall increases of 67% and 130%, respectively.

      Conclusion

      At a global scale, physical rehabilitation needs per capita are growing for all major condition groups, with musculoskeletal and pain conditions currently accounting for over half of those needs. Countries of varying income level have different typologies and evolutionary trends in their rehabilitation needs.

      Keywords

      List of abbreviations:

      99% CI (99% confidence interval), GBD (Global Burden of Disease), HIC (high-income country), HIV (human immunodeficiency virus), LIC (low-income country), LMIC (lower-middle-income country), UMIC (upper-middle-income country), YLD (years lived with disability)
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