On the road to universal health care in Indonesia, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.
On the road to universal health care in Indonesia, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.
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DOI：
10.1016/s0140-6736(18)30595-6
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发表时间：
2018-08-18
期刊：
影响因子：
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通讯作者：
Hay SI
中科院分区：
文献类型：
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作者：
Mboi N;Murty Surbakti I;Trihandini I;Elyazar I;Houston Smith K;Bahjuri Ali P;Kosen S;Flemons K;Ray SE;Cao J;Glenn SD;Miller-Petrie MK;Mooney MD;Ried JL;Nur Anggraini Ningrum D;Idris F;Siregar KN;Harimurti P;Bernstein RS;Pangestu T;Sidharta Y;Naghavi M;Murray CJL;Hay SI
随着印度尼西亚采取行动为所有公民提供医疗保险，了解发病率和死亡率的模式对于分配资源和解决不平等问题十分重要。2016年全球疾病负担研究(GBD 2016)估计了过早死亡和残疾的来源，这可以为改善医疗保健的政策提供参考。我们使用GBD 2016年的结果来衡量印度尼西亚和7个比较国家的333个原因的具体原因死亡、寿命损失年数、残疾寿命、残疾调整寿命年(DALY)、出生时预期寿命、健康预期寿命和风险因素。估计是使用GBD 2016中概述的方法按地点、年份、年龄和性别得出的。使用社会人口指数，我们为每个指标生成了期望值，并将这些值与观察结果进行了比较。在印度尼西亚，1990至2016年间，预期寿命增加了8.0岁(95%不确定区间[UI]7·3-8·8)至71·7岁(71·0-72·3)：男性增加了7·4岁(6·4-8·6)，女性增加了8·7岁(7·8-9·5)。因传染病、孕产妇、新生儿和营养原因导致的DALY总数下降58.6%(95%UI 55·6~61·6)，从4380万(95%UI 41·4~46·5)下降到1810万(16.8~19.6)，而非传染病DALY总数上升。在粗率和年龄标化率方面，由于受伤而导致的DALYs都有所下降。2016年导致DALY的三大原因是缺血性心脏病、脑血管疾病和糖尿病。饮食风险是DALY负担的主要贡献者，占2016年DALY的13.6%(11.8-15.4)。在过去的27年里，印度尼西亚的许多指标的健康状况都有所改善。死亡人数上升和非传染性疾病负担日益加重在一定程度上抵消了这些改善。为了保持和增加健康成果，需要进一步开展工作，以确定成功的干预措施并改善健康公平。比尔和梅林达·盖茨基金会。
As Indonesia moves to provide health coverage for all citizens, understanding patterns of morbidity and mortality is important to allocate resources and address inequality. The Global Burden of Disease 2016 study (GBD 2016) estimates sources of early death and disability, which can inform policies to improve health care. We used GBD 2016 results for cause-specific deaths, years of life lost, years lived with disability, disability-adjusted life-years (DALYs), life expectancy at birth, healthy life expectancy, and risk factors for 333 causes in Indonesia and in seven comparator countries. Estimates were produced by location, year, age, and sex using methods outlined in GBD 2016. Using the Socio-demographic Index, we generated expected values for each metric and compared these against observed results. In Indonesia between 1990 and 2016, life expectancy increased by 8·0 years (95% uncertainty interval [UI] 7·3–8·8) to 71·7 years (71·0–72·3): the increase was 7·4 years (6·4–8·6) for males and 8·7 years (7·8–9·5) for females. Total DALYs due to communicable, maternal, neonatal, and nutritional causes decreased by 58·6% (95% UI 55·6–61·6), from 43·8 million (95% UI 41·4–46·5) to 18·1 million (16·8–19·6), whereas total DALYs from non-communicable diseases rose. DALYs due to injuries decreased, both in crude rates and in age-standardised rates. The three leading causes of DALYs in 2016 were ischaemic heart disease, cerebrovascular disease, and diabetes. Dietary risks were a leading contributor to the DALY burden, accounting for 13·6% (11·8–15·4) of DALYs in 2016. Over the past 27 years, health across many indicators has improved in Indonesia. Improvements are partly offset by rising deaths and a growing burden of non-communicable diseases. To maintain and increase health gains, further work is needed to identify successful interventions and improve health equity. The Bill & Melinda Gates Foundation.