The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions
The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions
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DOI：
10.1016/s2214-109x(19)30172-x
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发表时间：
2019-07-01
影响因子：
34.3
通讯作者：
Harding, Richard
中科院分区：
文献类型：
--
作者：
Sleeman, Katherine E.;de Brito, Maja;Harding, Richard
背景严重的危及生命和限制生命的疾病给社会和卫生系统带来了巨大的负担。了解这一负担未来将如何演变，对于为减轻痛苦和防止卫生系统削弱的政策提供信息至关重要。我们的目标是根据世界地区、年龄组和健康状况预测到2060年需要姑息治疗的严重健康相关痛苦的全球负担。方法我们预测了柳叶刀姑息治疗和疼痛缓解委员会定义的未来严重健康相关痛苦的负担，方法将世卫组织2016年至1960年的死亡率预测与20种最常与需要姑息治疗的症状相关的疾病的生理和心理症状患病率的估计相结合。预测以绝对数字和与2016年基线数据相比的比例变化进行了说明。结果按世界银行收入地区和世卫组织地理区域进行分层。结果发现，到2060年，估计将有4800万人(占全球所有死亡人数的47%)死于与健康相关的严重痛苦，比2016年的2600万人增加87%。其中83%的死亡将发生在低收入和中等收入国家。与健康有关的严重痛苦将在所有区域增加，其中低收入国家的比例上升幅度最大(2016至2060年间增加155%)。在全球范围内，与健康有关的严重痛苦将在70岁或以上的老年人中增长最快(2016至2060年间增长183%)。从绝对值来看，这将受到癌症死亡人数上升的推动(2016年至2060年期间有1600万人，增长了109%)。严重相关疾病增加比例最高的疾病将是痴呆症(600万人，2016至2060年增长264%)。据解释，到2060年，严重健康相关疾病的负担将几乎翻一番，增长最快的是低收入国家、老年人和痴呆症患者。立即采取全球行动，将姑息治疗纳入卫生系统，在伦理和经济上势在必行。版权所有(C)2019作者(S)。爱思唯尔有限公司出版。
Background Serious life-threatening and life-limiting illnesses place an enormous burden on society and health systems. Understanding how this burden will evolve in the future is essential to inform policies that alleviate suffering and prevent health system weakening. We aimed to project the global burden of serious health-related suffering requiring palliative care until 2060 by world regions, age groups, and health conditions.Methods We projected the future burden of serious health-related suffering as defined by the lancet Commission on Palliative Care and Pain Relief, by combining WHO mortality projections (2016-60) with estimates of physical and psychological symptom prevalence in 20 conditions most often associated with symptoms requiring palliative care. Projections were described in terms of absolute numbers and proportional change compared with the 2016 baseline data. Results were stratified by World Bank income regions and WHO geographical regions.Findings By 2060, an estimated 48 million people (47% of all deaths globally) will die with serious health-related suffering, which represents an 87% increase from 26 million people in 2016. 83% of these deaths will occur in low-income and middle-income countries. Serious health-related suffering will increase in all regions, with the largest proportional rise in low-income countries (155% increase between 2016 and 2060). Globally, serious health-related suffering will increase most rapidly among people aged 70 years or older (183% increase between 2016 and 2060). In absolute terms, it will be driven by rises in cancer deaths (16 million people, 109% increase between 2016 and 2060). The condition with the highest proportional increase in serious-related suffering will be dementia (6 million people, 264% increase between 2016 and 2060).Interpretation The burden of serious health-related suffering will almost double by 2060, with the fastest increases occurring in low-income countries, among older people, and people with dementia. Immediate global action to integrate palliative care into health systems is an ethical and economic imperative. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.