Trends in the burden and quality of care for upper gastrointestinal diseases from 1990 to 2021: An analysis of the global burden of disease study 2021.

Background: Upper gastrointestinal (GI) diseases, primarily gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis and duodenitis (GD), are highly prevalent, chronic, and recurrent conditions worldwide, imposing a substantial burden on population health and quality of life. However, long-term trends in their quality of care and the disease-specific burden remain poorly characterized. This study aimed to analyze global trends in the disease burden and quality of care for upper-GI diseases, from 1990 to 2021. Methods: Based on data from the Global Burden of Disease Study 2021, we analyzed the global temporal trends in the incidence, prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost, years lived with disability, and their age-standardized rates of upper-GI diseases and the three main subtypes (GERD, PUD and GD), from 1990 to 2021. We further assessed trends in the Quality-of-Care Index (QCI) and examined variations across regions, sexes, and age groups. Additionally, we conducted cross-national inequality analyses. Results: From 1990 to 2021, global case numbers of upper-GI diseases increased by 77.185% for incidence and 81.033% for prevalence, with modest rises in age-standardized incidence rate (ASIR; +1.794%) and prevalence rate (+2.130%). Age-standardized mortality rate and DALYs rate (ASDR) declined by 59.778% and 43.041%, respectively. The global QCI continued to rise, reaching 92.403 in 2021 with an estimated annual percentage change (EAPC) of 0.269 (95% CI: 0.262–0.276). Regions with lower sociodemographic indices (SDI) showed poorer care quality but greater improvement (EAPC =0.561). Females consistently maintained higher QCI scores than males, though this sex gap gradually narrowed. QCI declined with advancing age in elderly populations. Cross-national inequality analysis revealed that in 2021, the global slope index of inequality and concentration index for QCI were 9.612 (95% CI: 7.515–11.708) and 0.010 (95% CI: 0.005–0.014), respectively, showing reductions compared to 1990. Analysis of the component diseases revealed marked heterogeneity: the ASIR and ASDR for GERD showed an upward trend, whereas the corresponding indicators for PUD and GD declined substantially. Conclusion: During 1990–2021, despite the global trends of improvements in disease burden and the quality of care for upper-GI diseases, heterogeneity among diseases and inequalities in healthcare quality remain. Future efforts should prioritize international collaboration, particularly through targeted health system support for low-SDI countries, and adopt disease-specific, differentiated interventions aligned with each condition's epidemiological profile, to advance global health equity goals. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Journal of Gastroenterology is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)