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dc.contributor.authorBarber, Ryan M
dc.contributor.authorFullman, Nancy
dc.contributor.authorSorensen, Reed JD
dc.contributor.authorBollyky, Thomas
dc.contributor.authorMcKee, Martin
dc.contributor.authorNolte, Ellen
dc.contributor.authorAbajobir, Amanuel Alemu
dc.contributor.authorAbate, Kalkidan Hassen
dc.contributor.authorAbbafati, Cristiana
dc.contributor.authorAbbas, Kaja M
dc.contributor.authorAbd-Allah, Foad
dc.contributor.authorAbdulle, Abdishakur M
dc.contributor.authorAbdurahman, Ahmed Abdulahi
dc.contributor.authorAbera, Semaw Ferede
dc.contributor.authorAbraham, Biju
dc.contributor.authorAbreha, Girmatsion Fisseha
dc.contributor.authorAdane, Kelemework
dc.contributor.authorAdelekan, Ademola Lukman
dc.contributor.authorAdetifa, Ifedayo Morayo O
dc.contributor.authorAfshin, Ashkan
dc.contributor.authorAgarwal, Arnav
dc.contributor.authorAgarwal, Sanjay Kumar
dc.contributor.authorAgarwal, Sunilkumar
dc.contributor.authorAgrawal, Anurag
dc.contributor.authorKiadaliri, Aliasghar Ahmad
dc.contributor.authorAhmadi, Alireza
dc.contributor.authorAhmed, Kedir Yimam
dc.contributor.authorAhmed, Muktar Beshir
dc.contributor.authorAkinyemi, Rufus Olusola
dc.contributor.authorAkinyemiju, Tomi F
dc.contributor.authorAkseer, Nadia
dc.contributor.authorAl-Aly, Ziyad
dc.contributor.authorAlam, Khurshid
dc.contributor.authorAlam, Noore
dc.contributor.authorAlam, Sayed Saidul
dc.contributor.authorAlemu, Zewdie Aderaw
dc.contributor.authorAlene, Kefyalew Addis
dc.contributor.authorAlexander, Lily
dc.contributor.authorAli, Raghib
dc.contributor.authorAli, Syed Danish
dc.contributor.authorAlizadeh-Navaei, Reza
dc.contributor.authorAlkerwi, Ala'a
dc.contributor.authorAlla, François
dc.contributor.authorAllebeck, Peter
dc.contributor.authorAllen, Christine
dc.contributor.authorAl-Raddadi, Rajaa
dc.contributor.authorAlsharif, Ubai
dc.contributor.authorAltirkawi, Khalid A
dc.contributor.authorAlvarez Martin, Elena
dc.contributor.authorAlvis-Guzman, Nelson
dc.contributor.authorAmare, Azmeraw T
dc.contributor.authorAmini, Erfan
dc.contributor.authorAmmar, Walid
dc.contributor.authorAmo-Adjei, Joshu
dc.contributor.authorAmoako, Yaw Ampem
dc.contributor.authorAnderson, Benjamin O
dc.contributor.authorAndroudi, Sofia
dc.contributor.authorAnsari, Hossein
dc.contributor.authorAnsha, Mustafa Geleto
dc.contributor.authorT Antonio, Carl Abelardo
dc.contributor.authorÄrnlöv, Johan
dc.contributor.authorArtaman, Al
dc.contributor.authorAsayesh, Hamid
dc.contributor.authorAssadi, Reza
dc.contributor.authorAstatkie, Ayalew
dc.contributor.authorAtey, Tesfay Mehari
dc.contributor.authorAtique, Suleman
dc.contributor.authorAtnafu, Niguse Tadele
dc.contributor.authorAtre, Sachin R
dc.contributor.authorAvila-Burgos, Leticia
dc.contributor.authorArthur Avokpaho, Euripide Frinel G
dc.contributor.authorAyala Quintanilla, Beatriz Paulina
dc.contributor.authorAwasthi, Ashish
dc.contributor.authorAyele, Nebiyu Negussu
dc.contributor.authorAzzopardi, Peter
dc.contributor.authorBa Saleem, Huda Omer
dc.contributor.authorBärnighausen, Till
dc.contributor.authorBacha, Umar
dc.contributor.authorBadawi, Alaa
dc.contributor.authorBanerjee, Amitava
dc.contributor.authorBarac, Aleksandra
dc.contributor.authorBarboza, Miguel A
dc.contributor.authorBarker-Collo, Suzanne L
dc.contributor.authorBarrero, Lope H
dc.contributor.authorBasu, Sanjay
dc.contributor.authorBaune, Bernhard T
dc.contributor.authorBaye, Kaleab
dc.contributor.authorBayou, Yibeltal Tebekaw
dc.contributor.authorBazargan-Hejazi, Shahrzad
dc.contributor.authorBedi, Neeraj
dc.contributor.authorBeghi, Ettore
dc.contributor.authorBéjot, Yannick
dc.contributor.authorBello, Aminu K
dc.contributor.authorBennett, Derrick A
dc.contributor.authorBensenor, Isabela M
dc.contributor.authorBerhane, Adugnaw
dc.contributor.authorBernabé, Eduardo
dc.contributor.authorBernal, Oscar Alberto
dc.contributor.authorBeyene, Addisu Shunu
dc.contributor.authorBeyene, Tariku Jibat
dc.contributor.authorBhutta, Zulfiqar A
dc.contributor.authorBiadgilign, Sibhatu
dc.contributor.authorBikbov, Boris
dc.contributor.authorBirlik, Sait Mentes
dc.contributor.authorBirungi, Charles
dc.contributor.authorBiryukov, Stan
dc.contributor.authorBisanzio, Donal
dc.contributor.authorBizuayehu, Habtamu Mellie
dc.contributor.authorBose, Dipan
dc.contributor.authorBrainin, Michael
dc.contributor.authorBrauer, Michael
dc.contributor.authorBrazinova, Alexandra
dc.contributor.authorBreitborde, Nicholas JK
dc.contributor.authorBrenner, Hermann
dc.contributor.authorButt, Zahid A
dc.contributor.authorCárdenas, Rosario
dc.contributor.authorCahuana-Hurtado, Lucero
dc.contributor.authorCampos-Nonato, Ismael Ricardo
dc.contributor.authorCar, Josip
dc.contributor.authorCarrero, Juan Jesus
dc.contributor.authorCasey, Daniel
dc.contributor.authorCaso, Valeria
dc.contributor.authorCastañeda-Orjuela, Carlos A
dc.contributor.authorCastillo Rivas, Jacqueline
dc.contributor.authorCatalá-López, Ferrán
dc.contributor.authorCecilio, Pedro
dc.contributor.authorCercy, Kelly
dc.contributor.authorCharlson, Fiona J
dc.contributor.authorChen, Alan Z
dc.contributor.authorChew, Adrienne
dc.contributor.authorChibalabala, Mirriam
dc.contributor.authorChibueze, Chioma Ezinne
dc.contributor.authorChisumpa, Vesper Hichilombwe
dc.contributor.authorChitheer, Abdulaal A
dc.contributor.authorChowdhury, Rajiv
dc.contributor.authorChristensen, Hanne
dc.contributor.authorChristopher, Devasahayam Jesudas
dc.contributor.authorCiobanu, Liliana G
dc.contributor.authorCirillo, Massimo
dc.contributor.authorCoggeshall, Megan S
dc.contributor.authorCooper, Leslie Trumbull
dc.contributor.authorCortinovis, Monica
dc.contributor.authorCrump, John A
dc.contributor.authorDalal, Koustuv
dc.contributor.authorDanawi, Hadi
dc.contributor.authorDandona, Lalit
dc.contributor.authorDandona, Rakhi
dc.contributor.authorDargan, Paul I
dc.contributor.authorNeves, Jose Das
dc.contributor.authorDavey, Gail
dc.date.accessioned2020-07-21T22:22:00Z
dc.date.available2020-07-21T22:22:00Z
dc.date.issued2017-07-15
dc.identifier.otherhttps://doi.org/10.1016/S0140-6736(17)30818-8
dc.identifier.urihttp://repositorio-indicasat.org.pa/handle/123456789/213
dc.descriptionBackground National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time.en_US
dc.description.abstractBackground National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time.en_US
dc.language.isoengen_US
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectie, amenable mortalityen_US
dc.subjectGBDen_US
dc.subjectr=0·88en_US
dc.titleHealthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015en_US
dc.typeinfo:eu-repo/semantics/articleen_US
dc.typeinfo:edu-repo/semantics/publishedVersion


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