ArticlePloS one2025
Global assessment of pain care quality for musculoskeletal disorders: Insights from the quality of care index (QCI) from 1990 to 2021.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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3 authors.
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Abstract
backgroundMusculoskeletal disorders (MSDs) represent a global primary cause of disability, affecting over 1.69 billion individuals and accounting for over 160 million disability-adjusted life years (DALYs) in 2021. Conventional metrics assess care quality inadequately, necessitating a multidimensional evaluation framework. Thus, this study introduces a novel metric - the Quality of Care Index (QCI) - to comprehensively evaluate the MSD landscape.
objectiveTo develop a novel QCI for MSDs and evaluate global trends, disparities, and drivers from 1990 to 2021.
methodsUsing Global Burden of Disease (GBD) 2021 data across 204 countries, we constructed a composite QCI integrating four domains: Pain Relief Rate(PRR), Opioid Use Rate(OUR), Need-Independent Coverage(NIC), and Patient Satisfaction(PS). These were standardized into a single index using Principal Component Analysis (PCA). Trends were analyzed via Estimated Annual Percentage Change (EAPC), with disparities assessed by Socio-Demographic Index (SDI) and geography.
resultsSignificant increases in MSDs prevalence (over 12.7% of low back pain; near doubling of osteoarthritis) and DALYs occurred globally, driven by aging populations. Geographic Paradox: Lower- and middle-income countries (LMICs; e.g., Vanuatu, Nicaragua, Central African Republic) achieved higher QCI scores than high-income nations (e.g., Italy, Germany, Japan). QCI improved in LMICs (notably for osteoarthritis/neck pain) but stagnated or even declined in high-income regions. DALYs correlated positively with SDI (R = 0.649-0.863; p < 0.001), with steepest rises in middle- and high-SDI areas for low back pain and osteoarthritis.
conclusionThe QCI scores reveal critical relationship between MSDs burden and care quality. High-income regions experience challenges of opioid overuse and stagnant patient satisfaction, while LMICs express gains in access and perceived relief. Implementing context-stratified strategies - de-implementing low-value care in high-SDI areas while scaling evidence-based access in resource-constrained regions - constitutes a critical pathway to equitably alleviate the global MSDs burden.
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