Temporal trend of population structure, burden of diseases, healthcare resources and expenditure in China, 2000-2019

Zhenguo Liang; Dongze Wu; Cui Guo; Jieruo Gu

doi:10.1136/bmjopen-2022-062091

Temporal trend of population structure, burden of diseases, healthcare resources and expenditure in China, 2000-2019

BMJ Open. 2023 Jan 18;13(1):e062091. doi: 10.1136/bmjopen-2022-062091.

Authors

Zhenguo Liang^#¹, Dongze Wu^#^{1

2}, Cui Guo^#^{3

4}, Jieruo Gu⁵

Affiliations

¹ Department of Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
² Department of Rheumatology and Immunology, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
³ Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
⁴ Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Hong Kong SAR, China.
⁵ Department of Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China gujieruo@mail.sysu.edu.cn.

^# Contributed equally.

Abstract

Objectives: To explore the evolutionary trend of population structure, disease burden, healthcare resources and expenditure in China, and to identify key domains that are most in need of intervention.

Design: A cross-sectional and longitudinal analysis.

Data source: Population and healthcare data from China Statistical Yearbook, and disease burden attributable to causes and risk factors from the Global Burden of Diseases between 2000 and 2019.

Measures and methods: We used the Joinpoint Regression Program to measure trends in population composition, population change, dependency ratio, healthcare institution, personnel, expenditure and disease burden from 2000 to 2019.

Results: Regarding the population in China between 2000 and 2019, a decreasing trend was observed among youth aged 0-14 years (average annual percent change (AAPC): -1.17), a slow rising trend was observed among individuals aged 15-64 years (AAPC: 1.10) and a rapidly increasing trend was observed among individuals older than 65 years (AAPC: 3.67). Astonishing increasing trends in healthcare institutions (AAPC: 3.97), medical personnel (AAPC: 3.26) and healthcare expenditures (AAPC: 15.28) were also observed. Among individuals younger than 70 years, neoplasms (AAPC: 0.54) and cardiovascular diseases (AAPC: 0.67) remained among the top three causes, while tobacco (AAPC: 0.22) remained a top three risk factor. However, while musculoskeletal disorders (AAPC: 1.88) were not a top three cause in 2000, they are a top three cause in 2019.

Conclusion: Comprehensive age/cause/risk factor-specific strategies are key to reconcile the tension among the triad of population ageing, disease burden and healthcare expenditure. The disease burden from cardiometabolic diseases, neoplasms and musculoskeletal disorders was identified as key domains that require intervention to reduce an increasing disease burden among individuals currently older than 70 years, as well as those approaching this age group.

Keywords: Health & safety; Health economics; Health policy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Age Factors
Cardiovascular Diseases* / epidemiology
China / epidemiology
Cross-Sectional Studies
Health Expenditures*
Humans
Incidence