作者
Justine I Davies, Sumithra Krishnamurthy Reddiar, Lisa R Hirschhorn, Cara Ebert, Maja-Emilia Marcus, Jacqueline A Seiglie, Zhaxybay Zhumadilov, Adil Supiyev, Lela Sturua, Bahendeka K Silver, Abla M Sibai, Sarah Quesnel-Crooks, Bolormaa Norov, Joseph K Mwangi, Omar Mwalim Omar, Roy Wong-McClure, Mary T Mayige, Joao S Martins, Nuno Lunet, Demetre Labadarios, Khem B Karki, Gibson B Kagaruki, Jutta M. A Jorgensen, Nahla C Hwalla, Dismand Houinato, Corine Houehanou, David Guwatudde, Mongal S Gurung, Pascal Bovet, Brice W Bicaba, Krishna K Aryal, Mohamed Msaidié, Glennis Andall-Brereton, Garry Brian, Andrew Stokes, Sebastian Vollmer, Till Bärnighausen, Rifat Atun, Pascal Geldsetzer, Jennifer Manne-Goehler, Lindsay M Jaacks
发表日期
2020/11/10
期刊
PLoS Medicine
出版商
PLOS
简介
Background
Cardiovascular diseases are leading causes of death, globally, and health systems that deliver quality clinical care are needed to manage an increasing number of people with risk factors for these diseases. Indicators of preparedness of countries to manage cardiovascular disease risk factors (CVDRFs) are regularly collected by ministries of health and global health agencies. We aimed to assess whether these indicators are associated with patient receipt of quality clinical care.
Methods and findings
We did a secondary analysis of cross-sectional, nationally representative, individual-patient data from 187,552 people with hypertension (mean age 48.1 years, 53.5% female) living in 43 low- and middle-income countries (LMICs) and 40,795 people with diabetes (mean age 52.2 years, 57.7% female) living in 28 LMICs on progress through cascades of care (condition diagnosed, treated, or controlled) for diabetes or hypertension, to indicate outcomes of provision of quality clinical care.
Data were extracted from national-level World Health Organization (WHO) Stepwise Approach to Surveillance (STEPS), or other similar household surveys, conducted between July 2005 and November 2016. We used mixed-effects logistic regression to estimate associations between each quality clinical care outcome and indicators of country development (gross domestic product [GDP] per capita or Human Development Index [HDI]); national capacity for the prevention and control of noncommunicable diseases (‘NCD readiness indicators’ from surveys done by WHO); health system finance (domestic government expenditure on health [as percentage …
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JI Davies, SK Reddiar, LR Hirschhorn, C Ebert… - PLoS medicine, 2020