2026-06-14T03:33:14Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/159482025-06-18T08:57:41Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19613
Repisalud
author
GBD 2019 Healthcare Access and Quality Collaborators
author
Catalá-López, Ferrán
funder
King Edward Medical University (Pakistán)
funder
Kuwait University (Kuwait)
funder
Romanian National Authority for Scientific Research and Innovation
funder
Romanian Ministry of Research Innovation and Digitalization
funder
Federal Ministry of Education & Research (Alemania)
funder
National Records of Scotland (Reino Unido)
funder
Medical Research Council (Reino Unido)
funder
Scottish Government (Reino Unido)
funder
Jatiya Kabi Kazi Nazrul Islam University (Bangladesh)
funder
Xiamen University Malaysia (Malasia)
funder
IRCCS Materno Infantile Burlo Garofolo (Italia)
funder
Edwards Lifesciences Foundation
funder
Manipal Academy of Higher Education (India)
funder
International Center of Medical Sciences Research (Pakistán)
funder
Ain Shams University (Egipto)
funder
INCLIVA Health Research Institute (España)
funder
Australian Government
funder
Bill & Melinda Gates Foundation
funder
Alexander von Humboldt Foundation
funder
Federal Ministry of Education & Research (Alemania)
funder
Unión Europea. Comisión Europea. H2020
funder
University of Aberdeen (Reino Unido)
funder
Novo Nordisk Foundation
funder
National Health and Medical Research Council (Australia)
funder
National Research, Development and Innovation Office (Hungria)
funder
Medical Research Council (Reino Unido)
funder
Ministero della Salute (Italia)
funder
Fondazione IRCCS. Istituto Nazionale dei Tumori
funder
King College London
funder
National Council for Scientific and Technological Development (Brasil)
funder
Fundação de Amparo à Pesquisa do Estado de São Paulo Minas Gerais (Brasil)
funder
Ministerio de Ciencia e Innovación. Centro de Excelencia Severo Ochoa (España)
funder
Government of Catalonia (España)
funder
Instituto de Salud Carlos III
funder
Centro de Investigación Biomédica en Red - CIBERSAM (Salud Mental)
funder
Canadian Institutes of Health Research
funder
Ministry of Education, Science and Technological Development (Serbia)
2023-05-03T14:03:46Z
2023-05-03T14:03:46Z
2022-12
Lancet Glob Health. 2022 Dec;10(12):e1715-e1743.
10.1016/S2214-109X(22)00429-6
2214-109X
The Lancet. Global health
36209761
http://hdl.handle.net/20.500.12105/15948
Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. Methods: We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Findings: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9-21·3), as well as among the young (22·5, 19·9-24·7), working (17·2, 15·2-19·1), and post-working (15·1, 13·2-17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6-33·0) on average in low-SDI countries to 83·4 (82·4-84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4-89·0), working (33·8-82·8), and post-working (30·4-79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young.
eng
Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019
research article
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AssessingPerformanceHealthcareAccess_2022.pdf
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AssessingPerformanceHealthcareAccess_2022.pdf.txt