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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
  1. Liangquan Lin
  1. School of Marxism, School of Humanities and Social Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
  1. Correspondence to Liangquan Lin, School of Marxism School of Humanities and Social Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; 1171437236{at}qq.com

Abstract

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 after 2002. Lower SDI regions exhibited a significant increase in incidence risk after 2012. Globally, the cohort effect showed a continually increasing incidence risk across sequential birth cohorts from 1900 to 1950.

Conclusion As the global population ageing intensifies alongside the increasing quantity of healthcare services provided, measures need to be taken to address the continuously rising burden of AEMT among the older population.

  • Adverse events, epidemiology and detection
  • Healthcare quality improvement
  • Health policy
  • Medical error, measurement/epidemiology
  • Patient safety

Data availability statement

Data are available in a public, open access repository. All data used in this study can be freely accessed at the GBD 2019 portal (http://ghdx.healthdata.org/gbd2019).

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Data availability statement

Data are available in a public, open access repository. All data used in this study can be freely accessed at the GBD 2019 portal (http://ghdx.healthdata.org/gbd2019).

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Footnotes

  • Contributors L-QL conceived the study, accessed and acquired the raw data, performed the primary analysis, prepared tables and figures, drafted the first manuscript, interpreted the data, critically reviewed and edited the manuscript. L-QL is responsible for the overall content as guarantor.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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