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National and subnational survey on diabetes burden and quality of care index in Iran: a systematic analysis of the global burden of disease study 1990–2019

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Abstract

Purpose

Diabetes care is one of the major healthcare problems. This study aimed to introduce a recently-developed Quality of Care Index (QCI) for type 2 diabetes and utilized it to compare different genders, age groups, and Iranian provinces.

Methods

From the Global Burden of Disease 1990–2019 database, we obtained primary epidemiologic measures and combined them to build four secondary indices, all indicating the quality of care provided to patients. We utilized the principal component analysis (PCA) method to calculate the substantial component named QCI (with a scale of 0–100). Gender inequality was shown by the gender disparity ratio (GDR), defining female to male QCI.

Results

National QCI ranged from 43.0 in 1990 to 38.6 in 2019. By excluding the more frequent outlier province; Tehran as the Capital of Iran, the QCI score reached 50.27 in 2019. The GDR decreased from 1.04 to 0.95. QCI indicated rather more favorable conditions in Iranian provinces with a higher socio-demographic index (SDI). Conversely, provinces with a lower SDI had worse QCI. In 2019, Tehran, the capital of Iran, with the highest (58.5), and South Khorasan with the lowest QCIs (0.4) were the two Iranian provinces’ extremes. Moreover, the elderly QCI improved in 2019.

Conclusion

During 1990–2019, there are remarkable disparities between Iran’s provinces, genders and age groups. The equitable and widespread provision of facilities should be considered along with the decentralization of healthcare resources.

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Data availability

The study protocol and data used in this work are available both from [https://www.protocols.io/view/quality-of-care-index-qci-bprjmm4n] and GBD Results Tool [http://ghdx.healthdata.org/gbd-results-tool].

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Acknowledgements

The authors thank the Institute for Health Metrics and Evaluation and also other researchers for their valuable contribution.

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Author notes

  1. Seyedeh Farzaneh Mousavi and Maryam Peimani contributed equally to this work.

Authors and Affiliations

  1. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Seyedeh Farzaneh Mousavi, Sahar Saeedi Moghaddam, Ozra Tabatabaei-Malazy, Erfan Ghasemi, Parnian Shobeiri & Negar Rezaei

  2. Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Seyedeh Farzaneh Mousavi, Maryam Peimani & Ensieh Nasli-Esfahani

  3. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Ozra Tabatabaei-Malazy, Negar Rezaei, Ensieh Nasli-Esfahani & Bagher Larijani

  4. Endocrinology and Metabolism Research Institute, Postal box: 1411713137, North Kargar Ave., Tehran, Iran

    Ensieh Nasli-Esfahani & Bagher Larijani

Authors
  1. Seyedeh Farzaneh Mousavi
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  2. Maryam Peimani
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  3. Sahar Saeedi Moghaddam
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Correspondence to Ensieh Nasli-Esfahani or Bagher Larijani.

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Table S1

Age-standardized QCI score and GDR score by age groups and gender for T2DM, in provinces of Iran, 1990 and 2019, with percentage change between 1990 and 2019. (DOCX 63 kb)

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Mousavi, S.F., Peimani, M., Moghaddam, S.S. et al. National and subnational survey on diabetes burden and quality of care index in Iran: a systematic analysis of the global burden of disease study 1990–2019. J Diabetes Metab Disord 21, 1599–1608 (2022). https://doi.org/10.1007/s40200-022-01108-x

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