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)To read this article in full you will need to make a payment
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References
- Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet. 2018; 392: 1684-1735
- Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories.Lancet. 2018; 392: 2052-2090
- Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet. 2018; 392: 1789-1858
- Strengthening health systems to provide rehabilitation services.Bull World Health Organ. 2017; 95: 167
- Rehabilitation: essential along the continuum of care.in: Disease control priorities. 3rd ed. 9. World Bank, Washington (DC)2017
- Health, functioning, and disability in older adults--present status and future implications.Lancet. 2015; 385: 563-575
- Aging, non-communicable diseases, and old-age disability in low- and middle-income countries: a challenge for global health.Int J Public Health. 2018; 63: 1011-1012
- Socio−demographic patterns of disability among older adult populations of low-income and middle-income countries: results from World Health Survey.Int J Public Health. 2016; 61: 337-345
- Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: a cohort study.Lancet. 2017; 389: 1619-1629
- Global need for physical rehabilitation: systematic analysis from the Global Burden of Disease Study 2017.Int J Environ Res Public Health. 2019; : 16
- Rehabilitation 2030: A call for action. The need to scale up rehabilitation.World Health Organization, Geneva, Switzerland2017
- Towards a conceptual description of physical and rehabilitation medicine.J Rehabil Med. 2011; 43: 760-764
- Rehabilitation the health strategy of the 21st century, really?.Arch Phys Med Rehabil. 2019; 100: 2212-2214
- Rehabilitation 2030: a call for action. Meeting report.World Health Organization, Geneva, Switzerland2017
- Systematic overview of economic evaluations of health-related rehabilitation.Disabil Health J. 2016; 9: 11-25
- Cost-effectiveness of cardiac rehabilitation: a systematic review.Heart. 2018; 104: 1403-1410
- Cost-effectiveness of physical therapy only and of usual care for various health conditions: systematic review.Phys Ther. 2016; 96: 774-786
- Needs and unmet needs for rehabilitation services: a scoping review.Disabil Rehabil. 2019; 41: 1227-1237
- A systematic review of access to rehabilitation for people with disabilities income countries.Int J Environ Res Public Health. 2018; 15
- Human resources for health (and rehabilitation): six rehab-workforce challenges for the century.Hum Resour Health. 2017; 15: 8
- Compliance with standards of practice for health-related rehabilitation in low and middle-income settings: development and implementation of a novel scoring method.Disabil Rehabil. 2019; 41: 2264-2271
- Crossing the global quality chasm: where does rehabilitation stand?.Arch Phys Med Rehabil. 2019; 100: 2215-2217
- Systematic reviews and clinical trials in rehabilitation: comprehensive analyses of publication trends.Arch Phys Med Rehabil. 2016; 97: 1853-1862.e1852
- Evolving trends in physiotherapy research publications between 2005 and 2015.Physiother Can. 2019 Aug 19; ([Epub ahead of print])
- 15 years of tracking physiotherapy evidence on PEDro, where are we now?.Br J Sports Med. 2015; 49: 907-909
- Disability weights for the Global Burden of Disease 2013 study.Lancet Glob Health. 2015; 3: e712-e723
- Musculoskeletal health conditions represent a global threat to healthy aging: a report for the 2015 World Health Organization World Report on Ageing and Health.Gerontologist. 2016; 56: S243-S255
- Measuring population ageing: an analysis of the Global Burden of Disease Study 2017.Lancet Pub Health. 2019; 4: e159-e167
- SCI longitudinal aging study: 40 years of research.Top Spinal Cord Inj Rehabil. 2015; 21: 189-200
- The increasing chronicity of HIV in sub-Saharan Africa: re-thinking “HIV as a long-wave event” in the era of widespread access to ART.Global Health. 2011; 7: 41
- Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disabilityfor 32 cancer groups, 1990 to 2015: a systematic analysis for the Global Burden of Disease Study.JAMA Oncol. 2017; 3: 524-548
- Health effects of overweight and obesity in 195 countries over 25 years.N Engl J Med. 2017; 377: 13-27
- The global obesity pandemic: shaped by global drivers and local environments.Lancet. 2011; 378: 804-814
- Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet. 2018; 392: 1995-2051
- Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016.Lancet. 2017; 390: 1084-1150
- Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet. 2018; 392: 1736-1788
- Developmental disabilities among children younger than 5 years in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.Lancet Glob Health. 2018; 6: e1100-e1121
- Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the Global Burden of Disease Study 2015.Lancet HIV. 2016; 3: e361-e387
- Burden of disease in Brazil, 1990-2016: a systematic subnational analysis for the Global Burden of Disease Study 2016.Lancet. 2018; 392: 760-775
- Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the Global Burden of Disease Study 2015.Lancet. 2017; 389: 1885-1906
- Members of minority and underserved communities set priorities for health research.Milbank Q. 2018; 96: 675-705
- The convention on the rights of persons with disabilities: a foundation for ethical disability and health research in developing countries.Am J Public Health. 2014; 104: 2037-2043
- Towards deep inclusion for equity−oriented health research priority−setting: a working model.Social Sci Med. 2016; 151: 215-224
- Exploring the ethics of global health research priority−setting.BMC Med Ethics. 2018; 19: 94
- The 10 largest public and philanthropic funders of health research in the world: what they fund and how they distribute their funds.Health Res Policy Syst. 2016; 14: 12
- Alignment of systematic reviews published in the Cochrane Database of Systematic Reviews and the Database of Abstracts and Reviews of Effectiveness with global burden-of-disease data: a bibliographic analysis.J Epidemiol Commun Health. 2015; 69: 708-714
- Global burden of eye and vision disease as reflected in the Cochrane Database of Systematic Reviews.JAMA Ophthalmol. 2015; 133: 25-31
- Global burden of skin disease as reflected in Cochrane Database of Systematic Reviews.JAMA Dermatol. 2014; 150: 945-951
- Comparing cutaneous research funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with 2010 Global Burden of Disease results.PLoS One. 2014; 9 (e102122)
- NIH disease funding levels and burden of disease.PLoS One. 2011; 6 (e16837)
- NSFC health research funding and burden of disease in China.PLoS One. 2014; 9: e111458
Article Info
Publication History
Published online: February 05, 2020
Footnotes
Disclosures: none
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
