Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019
Annie Haakenstad(Institute for Health Metrics and Evaluation), Jamal A Yearwood(Institute for Health Metrics and Evaluation), Nancy Fullman(Institute for Health Metrics and Evaluation), Corinne Bintz(Institute for Health Metrics and Evaluation), Kelly Bienhoff(Institute for Health Metrics and Evaluation), Marcia R. Weaver(Institute for Health Metrics and Evaluation), Vishnu Nandakumar(Institute for Health Metrics and Evaluation), Kate E LeGrand(Institute for Health Metrics and Evaluation), Megan Knight(Institute for Health Metrics and Evaluation), Cristiana Abbafati(Institute for Health Metrics and Evaluation), Mohsen Abbasi‐Kangevari(Institute for Health Metrics and Evaluation), Amir Abdoli(Institute for Health Metrics and Evaluation), Roberto Ariel Abeldaño Zúñiga(Institute for Health Metrics and Evaluation), Isaac Akinkunmi Adedeji(Institute for Health Metrics and Evaluation), Victor Adekanmbi(Institute for Health Metrics and Evaluation), Olatunji Adetokunboh(Institute for Health Metrics and Evaluation), Muhammad U. Afzal(Institute for Health Metrics and Evaluation), Saira Afzal(Institute for Health Metrics and Evaluation), Marcela Agudelo‐Botero(Institute for Health Metrics and Evaluation), Bright Opoku Ahinkorah(Institute for Health Metrics and Evaluation), Sajjad Ahmad(Institute for Health Metrics and Evaluation), Ali Ahmadi(Institute for Health Metrics and Evaluation), Sepideh Ahmadi(Institute for Health Metrics and Evaluation), Ali Ahmed(Institute for Health Metrics and Evaluation), Tarik A. Rashid, Budi Aji(Institute for Health Metrics and Evaluation), Wuraola Akande‐Sholabi(Institute for Health Metrics and Evaluation), Khurshid Alam(Institute for Health Metrics and Evaluation), Hanadi Al Hamad(Institute for Health Metrics and Evaluation), Robert Kaba Alhassan(Institute for Health Metrics and Evaluation), Liaqat Ali(Institute for Health Metrics and Evaluation), Vahid Alipour(Institute for Health Metrics and Evaluation), Syed Mohamed Aljunid(Institute for Health Metrics and Evaluation), Edward Kwabena Ameyaw(Institute for Health Metrics and Evaluation), Tarek Tawfik Amin(Institute for Health Metrics and Evaluation), Hubert Amu(Institute for Health Metrics and Evaluation), Dickson A Amugsi(Institute for Health Metrics and Evaluation), Robert Ancuceanu(Institute for Health Metrics and Evaluation), Pedro Prata Andrade(Institute for Health Metrics and Evaluation), Afifa Anjum(Institute for Health Metrics and Evaluation), Jalal Arabloo(Institute for Health Metrics and Evaluation), Morteza Arab‐Zozani(Institute for Health Metrics and Evaluation), Hany Ariffin(Institute for Health Metrics and Evaluation), Judie Arulappan(Institute for Health Metrics and Evaluation), Zahra Aryan(Institute for Health Metrics and Evaluation), Tahira Ashraf(Institute for Health Metrics and Evaluation), Desta Debalkie Atnafu(Institute for Health Metrics and Evaluation), Alok Atreya(Institute for Health Metrics and Evaluation), Marcel Ausloos(Institute for Health Metrics and Evaluation), Leticia Ávila‐Burgos(Institute for Health Metrics and Evaluation), Getinet Ayano(Institute for Health Metrics and Evaluation), Martin Amogre Ayanore(Institute for Health Metrics and Evaluation), Samad Azari(Institute for Health Metrics and Evaluation), Ashish Badiye(Institute for Health Metrics and Evaluation), Atif Amin Baig(Institute for Health Metrics and Evaluation), Mohan Bairwa(Institute for Health Metrics and Evaluation), Shankar M Bakkannavar(Institute for Health Metrics and Evaluation), Shrikala Baliga(Institute for Health Metrics and Evaluation), Palash Chandra Banik(Institute for Health Metrics and Evaluation), Till Bärnighausen(Institute for Health Metrics and Evaluation), Fabio Barra(Institute for Health Metrics and Evaluation), Amadou Barrow(Institute for Health Metrics and Evaluation), Sanjay Basu(Institute for Health Metrics and Evaluation), Mohsen Bayati(Institute for Health Metrics and Evaluation), Rebuma Belete(Institute for Health Metrics and Evaluation), Arielle Wilder Bell(Institute for Health Metrics and Evaluation), Devidas S. Bhagat(Institute for Health Metrics and Evaluation), Akshaya Srikanth Bhagavathula(Institute for Health Metrics and Evaluation), Pankaj Bhardwaj(Institute for Health Metrics and Evaluation), Nikha Bhardwaj(Institute for Health Metrics and Evaluation), Sonu Bhaskar(Institute for Health Metrics and Evaluation), Krittika Bhattacharyya(Institute for Health Metrics and Evaluation), Ashok Bhurtyal, Zulfiqar A Bhutta(Institute for Health Metrics and Evaluation), Sadia Bibi(Institute for Health Metrics and Evaluation), Ali Bijani(Institute for Health Metrics and Evaluation), Boris Bikbov(Institute for Health Metrics and Evaluation), Antonio Biondi(Institute for Health Metrics and Evaluation), Obasanjo Afolabi Bolarinwa(Institute for Health Metrics and Evaluation), Aimé Bonny(Institute for Health Metrics and Evaluation), Hermann Brenner(Institute for Health Metrics and Evaluation), Danilo Buonsenso(Institute for Health Metrics and Evaluation), Katrin Burkart(Institute for Health Metrics and Evaluation), Reinhard Busse(Institute for Health Metrics and Evaluation), Zahid A Butt(Institute for Health Metrics and Evaluation), Nadeem Shafique Butt(Institute for Health Metrics and Evaluation), Florentino Luciano Caetano dos Santos, Lucero Cahuana-Hurtado(Institute for Health Metrics and Evaluation), Luis Alberto Cámera(Institute for Health Metrics and Evaluation), Rosario Cárdenas(Institute for Health Metrics and Evaluation), Vera Lúcia Alves Carneiro(Institute for Health Metrics and Evaluation), Ferrán Catalá-López(Institute for Health Metrics and Evaluation), Joht Singh Chandan(Institute for Health Metrics and Evaluation), Jaykaran Charan(Institute for Health Metrics and Evaluation), Prachi P. Chavan(Institute for Health Metrics and Evaluation), Simiao Chen(Institute for Health Metrics and Evaluation), Shu Chen(Institute for Health Metrics and Evaluation), Sonali G Choudhari(Institute for Health Metrics and Evaluation), E. Chowdhury(Institute for Health Metrics and Evaluation), Mohiuddin Ahsanul Kabir Chowdhury(Institute for Health Metrics and Evaluation), Massimo Círillo(Institute for Health Metrics and Evaluation), Barbara Corso(Institute for Health Metrics and Evaluation), Omid Dadras(Institute for Health Metrics and Evaluation), Saad M A Dahlawi(Institute for Health Metrics and Evaluation), Xiaochen Dai(Institute for Health Metrics and Evaluation), Lalit Dandona(Institute for Health Metrics and Evaluation), Rakhi Dandona(Institute for Health Metrics and Evaluation), William James Dangel(Institute for Health Metrics and Evaluation), Claudio Alberto Dávila-Cervantes(Institute for Health Metrics and Evaluation), Kairat Davletov(Institute for Health Metrics and Evaluation), Keshab Deuba(Institute for Health Metrics and Evaluation), Meghnath Dhimal(Institute for Health Metrics and Evaluation), Mandira Lamichhane Dhimal(Institute for Health Metrics and Evaluation), Shirin Djalalinia(Institute for Health Metrics and Evaluation), Huyen Phuc(Institute for Health Metrics and Evaluation), Leila Doshmangir(Institute for Health Metrics and Evaluation), Bruce Bartholow Duncan(Institute for Health Metrics and Evaluation), Andem Effiong(Institute for Health Metrics and Evaluation), Elham Ehsani‐Chimeh(Institute for Health Metrics and Evaluation), Islam Y. Elgendy(Institute for Health Metrics and Evaluation), Muhammed Elhadi(Institute for Health Metrics and Evaluation), Iman El Sayed(Institute for Health Metrics and Evaluation), Maha El Tantawi(Institute for Health Metrics and Evaluation), Daniel Erku(Institute for Health Metrics and Evaluation), Sharareh Eskandarieh(Institute for Health Metrics and Evaluation), Jawad Fares(Institute for Health Metrics and Evaluation), Farshad Farzadfar(Institute for Health Metrics and Evaluation), Simone Ferrero(Institute for Health Metrics and Evaluation), Lorenzo Ferro Desideri(Institute for Health Metrics and Evaluation), Florian Fischer(Institute for Health Metrics and Evaluation), Nataliya A Foigt(Institute for Health Metrics and Evaluation), Masoud Foroutan(Institute for Health Metrics and Evaluation), Takeshi Fukumoto(Institute for Health Metrics and Evaluation), Péter Gaál(Institute for Health Metrics and Evaluation), Santosh Gaihre(Institute for Health Metrics and Evaluation), William M. Gardner(Institute for Health Metrics and Evaluation), Tushar Garg(Institute for Health Metrics and Evaluation), Abera Getachew Obsa(Institute for Health Metrics and Evaluation), Mansour Ghafourifard(Institute for Health Metrics and Evaluation), Ahmad Ghashghaee(Institute for Health Metrics and Evaluation), Nermin Ghith(Institute for Health Metrics and Evaluation), Syed Amir Gilani(Institute for Health Metrics and Evaluation), Paramjit Gill(Institute for Health Metrics and Evaluation), Salime Goharinezhad(Institute for Health Metrics and Evaluation), Mahaveer Golechha(Institute for Health Metrics and Evaluation), Jenny S. Guadamuz(Institute for Health Metrics and Evaluation), Yuming Guo(Institute for Health Metrics and Evaluation), Rajat Das Gupta(Institute for Health Metrics and Evaluation), Rajeev Gupta(Institute for Health Metrics and Evaluation), Vivek Gupta(Institute for Health Metrics and Evaluation), Veer Bala Gupta(Institute for Health Metrics and Evaluation), Mohammad Hamiduzzaman(Institute for Health Metrics and Evaluation), Asif Hanif(Institute for Health Metrics and Evaluation), Josep María Haro(Institute for Health Metrics and Evaluation), Ahmed I Hasaballah(Institute for Health Metrics and Evaluation), Md. Mehedi Hasan(Institute for Health Metrics and Evaluation), M. Tasdik Hasan(Institute for Health Metrics and Evaluation), Abdiwahab Hashi(Institute for Health Metrics and Evaluation), Simon I Hay(Institute for Health Metrics and Evaluation), Khezar Hayat(Institute for Health Metrics and Evaluation), Mohammad Heidari(Institute for Health Metrics and Evaluation), Golnaz Heidari(Institute for Health Metrics and Evaluation), Nathaniel J Henry(Institute for Health Metrics and Evaluation), Claudiu Herţeliu(Institute for Health Metrics and Evaluation), Ramesh Holla(Institute for Health Metrics and Evaluation), Sahadat Hossain(Institute for Health Metrics and Evaluation), Sheikh Jamal Hossain(Institute for Health Metrics and Evaluation), Mohammad Bellal Hossain(Institute for Health Metrics and Evaluation), Mehdi Hosseinzadeh(Institute for Health Metrics and Evaluation), Sorin Hostiuc(Institute for Health Metrics and Evaluation), Soodabeh Hoveidamanesh(Institute for Health Metrics and Evaluation), Vivian Chia‐Rong Hsieh(Institute for Health Metrics and Evaluation), Guoqing Hu(Institute for Health Metrics and Evaluation), Junjie Huang(Institute for Health Metrics and Evaluation), M. Mamun Huda(Institute for Health Metrics and Evaluation), Susan C. Ifeagwu(Institute for Health Metrics and Evaluation), Kevin S Ikuta(Institute for Health Metrics and Evaluation), Olayinka Stephen Ilesanmi(Institute for Health Metrics and Evaluation), Seyed Sina Naghibi Irvani(Institute for Health Metrics and Evaluation), Rakibul M. Islam(Institute for Health Metrics and Evaluation), Sheikh Mohammed Shariful Islam(Institute for Health Metrics and Evaluation), Nahlah Elkudssiah Ismail(Institute for Health Metrics and Evaluation), Hiroyasu Iso(Institute for Health Metrics and Evaluation), Gaetano Isola(Institute for Health Metrics and Evaluation), Ramaiah Itumalla(Institute for Health Metrics and Evaluation), Masao Iwagami(Institute for Health Metrics and Evaluation), Mohammad Ali Jahani(Institute for Health Metrics and Evaluation), Nader Jahanmehr(Institute for Health Metrics and Evaluation), Rajesh Jain(Institute for Health Metrics and Evaluation), Mihajlo Jakovljević(Institute for Health Metrics and Evaluation), Manthan D Janodia(Institute for Health Metrics and Evaluation), Sathish Kumar Jayapal(Institute for Health Metrics and Evaluation), Shubha Jayaram(Institute for Health Metrics and Evaluation), Ravi Prakash Jha(Institute for Health Metrics and Evaluation), Jost B Jonas(Institute for Health Metrics and Evaluation), Tamás Joó(Institute for Health Metrics and Evaluation), Nitin Joseph(Institute for Health Metrics and Evaluation), Mikk Jürisson(Institute for Health Metrics and Evaluation), Ali Kabir(Institute for Health Metrics and Evaluation), Leila R Kalankesh(Institute for Health Metrics and Evaluation), Rohollah Kalhor(Institute for Health Metrics and Evaluation), Aruna M. Kamath(Institute for Health Metrics and Evaluation), Kaloyan Kamenov(Institute for Health Metrics and Evaluation), Himal Kandel(Institute for Health Metrics and Evaluation), Rami S. Kantar(Institute for Health Metrics and Evaluation), Neeti Kapoor(Institute for Health Metrics and Evaluation), Marina Karanikolos(Institute for Health Metrics and Evaluation), Srinivasa Vittal Katikireddi(Institute for Health Metrics and Evaluation), Taras Kavetskyy(Institute for Health Metrics and Evaluation), Norito Kawakami(Institute for Health Metrics and Evaluation), Gbenga A Kayode(Institute for Health Metrics and Evaluation), Leila Keikavoosi-Arani(Institute for Health Metrics and Evaluation), Mohammad Keykhaei(Institute for Health Metrics and Evaluation), Yousef Khader(Institute for Health Metrics and Evaluation), Himanshu Khajuria(Institute for Health Metrics and Evaluation), Rovshan Khalilov(Institute for Health Metrics and Evaluation), Mohammad Khammarnia(Institute for Health Metrics and Evaluation), Md Nuruzzaman Khan(Institute for Health Metrics and Evaluation), Moien AB Khan(Institute for Health Metrics and Evaluation), Maseer Khan(Institute for Health Metrics and Evaluation), Mehdi Khezeli(Institute for Health Metrics and Evaluation), Min Seo Kim(Institute for Health Metrics and Evaluation), Yun Jin Kim(Institute for Health Metrics and Evaluation), Sezer Kısa(Institute for Health Metrics and Evaluation), Adnan Kısa(Institute for Health Metrics and Evaluation), Vitalii Klymchuk(Institute for Health Metrics and Evaluation), Kamrun Nahar Koly(Institute for Health Metrics and Evaluation), Oleksii Korzh(Institute for Health Metrics and Evaluation), Soewarta Kosen(Institute for Health Metrics and Evaluation), Parvaiz A Koul(Institute for Health Metrics and Evaluation), Barthélémy Kuate Defo(Institute for Health Metrics and Evaluation), G Anil Kumar(Institute for Health Metrics and Evaluation), Dian Kusuma(Institute for Health Metrics and Evaluation), Hmwe Hmwe Kyu(Institute for Health Metrics and Evaluation), Anders Larsson(Institute for Health Metrics and Evaluation), Savita Lasrado(Institute for Health Metrics and Evaluation), Wei‐Chen Lee(Institute for Health Metrics and Evaluation), Yo Han Lee(Institute for Health Metrics and Evaluation), Chiachi Bonnie Lee(Institute for Health Metrics and Evaluation), Shanshan Li(Institute for Health Metrics and Evaluation), Giancarlo Lucchetti(Institute for Health Metrics and Evaluation), Preetam Mahajan(Institute for Health Metrics and Evaluation), Azeem Majeed(Institute for Health Metrics and Evaluation), Alaa Makki(Institute for Health Metrics and Evaluation), Reza Malekzadeh(Institute for Health Metrics and Evaluation), Ahmad Azam Malik(Institute for Health Metrics and Evaluation), Déborah Carvalho Malta(Institute for Health Metrics and Evaluation), Mohammad Alì Mansournia, LG Mantovani(Institute for Health Metrics and Evaluation), Adolfo Martínez Valle(Institute for Health Metrics and Evaluation), Francisco Rogerlândio Martins‐Melo(Institute for Health Metrics and Evaluation), Seyedeh Zahra Masoumi(Institute for Health Metrics and Evaluation), Manu Raj Mathur(Institute for Health Metrics and Evaluation), Richard J. Maude(Institute for Health Metrics and Evaluation), Pallab K Maulik(Institute for Health Metrics and Evaluation), Martin McKee(Institute for Health Metrics and Evaluation), Walter Mendoza(Institute for Health Metrics and Evaluation), Ritesh G. Menezes(Institute for Health Metrics and Evaluation), George A. Mensah(Institute for Health Metrics and Evaluation), Atte Meretoja(Institute for Health Metrics and Evaluation), Tuomo J Meretoja(Institute for Health Metrics and Evaluation), Tomislav Meštrović(Institute for Health Metrics and Evaluation), Irmina Maria Michałek(Institute for Health Metrics and Evaluation), Erkin М Мirrakhimov(Institute for Health Metrics and Evaluation), Awoke Misganaw(Institute for Health Metrics and Evaluation), Sanjeev Misra(Institute for Health Metrics and Evaluation), Babak Moazen(Institute for Health Metrics and Evaluation), Mokhtar Mohammadi(Institute for Health Metrics and Evaluation), Shafiu Mohammed(Institute for Health Metrics and Evaluation), Modhurima Moitra(Institute for Health Metrics and Evaluation), Ali H. Mokdad(Institute for Health Metrics and Evaluation), Mariam Molokhia(Institute for Health Metrics and Evaluation), Lorenzo Monasta(Institute for Health Metrics and Evaluation), Mohammad Ali Moni(Institute for Health Metrics and Evaluation), Ghobad Moradi(Institute for Health Metrics and Evaluation), Rafael Silveira Moreira(Institute for Health Metrics and Evaluation), Jonathan F Mosser(Institute for Health Metrics and Evaluation), Ebrahim Mostafavi(Institute for Health Metrics and Evaluation), Simin Mouodi(Institute for Health Metrics and Evaluation), Ahamarshan Jayaraman Nagarajan(Institute for Health Metrics and Evaluation), Chie Nagata(Institute for Health Metrics and Evaluation), Mohsen Naghavi(Institute for Health Metrics and Evaluation), Vinay Nangia(Institute for Health Metrics and Evaluation), Sreenivas Narasimha Swamy(Institute for Health Metrics and Evaluation), Aparna Ichalangod Narayana(Institute for Health Metrics and Evaluation), Bruno Ramos Nascimento(Institute for Health Metrics and Evaluation), Hasan Nassereldine(Institute for Health Metrics and Evaluation), Biswa Prakash Nayak(Institute for Health Metrics and Evaluation), Javad Nazari(Institute for Health Metrics and Evaluation), Ionuţ Negoi(Institute for Health Metrics and Evaluation), Samata Nepal(Institute for Health Metrics and Evaluation), Sandhya Neupane Kandel(Institute for Health Metrics and Evaluation), Josephine W Ngunjiri(Institute for Health Metrics and Evaluation), Huong Lan Thi Nguyen(Institute for Health Metrics and Evaluation), Cuong Tat Nguyen(Institute for Health Metrics and Evaluation), Dina Nur Anggraini Ningrum(Institute for Health Metrics and Evaluation), Jean Jacques Noubiap(Institute for Health Metrics and Evaluation), Bogdan Oancea(Institute for Health Metrics and Evaluation), Onome Bright Oghenetega(Institute for Health Metrics and Evaluation), In‐Hwan Oh(Institute for Health Metrics and Evaluation), Andrew T Olagunju(Institute for Health Metrics and Evaluation), Babayemi O. Olakunde(Institute for Health Metrics and Evaluation), Ahmed Omar Bali(Institute for Health Metrics and Evaluation), Emad Omer(Institute for Health Metrics and Evaluation), Obinna Onwujekwe(Institute for Health Metrics and Evaluation), Adrian Oţoiu(Institute for Health Metrics and Evaluation), Jagadish Rao Padubidri(Institute for Health Metrics and Evaluation), Raffaele Palladino(Institute for Health Metrics and Evaluation), Adrian Pană(Institute for Health Metrics and Evaluation), Songhomitra Panda‐Jonas(Institute for Health Metrics and Evaluation), Seithikurippu R. Pandi‐Perumal(Institute for Health Metrics and Evaluation), Shahina Pardhan(Institute for Health Metrics and Evaluation), Deepak Kumar Pasupula(Institute for Health Metrics and Evaluation), Praveen Kumar Pathak(Institute for Health Metrics and Evaluation), George Patton(Institute for Health Metrics and Evaluation), Shrikant Pawar(Institute for Health Metrics and Evaluation), Jeevan Pereira(Institute for Health Metrics and Evaluation), Manju Pilania(Institute for Health Metrics and Evaluation), Bakhtiar Piroozi(Institute for Health Metrics and Evaluation), Vivek Podder(Institute for Health Metrics and Evaluation), Khem Narayan Pokhrel, Maarten J. Postma(Institute for Health Metrics and Evaluation), Sergio I. Prada(Institute for Health Metrics and Evaluation), Zahiruddin Quazi Syed(Institute for Health Metrics and Evaluation), Navid Rabiee(Institute for Health Metrics and Evaluation), Raghu Radhakrishnan, Md. Mosfequr Rahman(Institute for Health Metrics and Evaluation), Mosiur Rahman(Institute for Health Metrics and Evaluation), Mahfuzar Rahman(Institute for Health Metrics and Evaluation), Mohammad Hifz Ur Rahman(Institute for Health Metrics and Evaluation), Amir M. Rahmani(Institute for Health Metrics and Evaluation), Chhabi Lal Ranabhat(Institute for Health Metrics and Evaluation), Chythra R Rao(Institute for Health Metrics and Evaluation), Sowmya J Rao(Institute for Health Metrics and Evaluation), Davide Rasella(Institute for Health Metrics and Evaluation), Salman Rawaf(Institute for Health Metrics and Evaluation), David Laith Rawaf(Institute for Health Metrics and Evaluation), Lal Rawal(Institute for Health Metrics and Evaluation), André M. N. Renzaho(Institute for Health Metrics and Evaluation), Bhageerathy Reshmi(Institute for Health Metrics and Evaluation), Serge Resnikoff(Institute for Health Metrics and Evaluation), Aziz Rezapour(Institute for Health Metrics and Evaluation), Seyed Mohammad Riahi(Institute for Health Metrics and Evaluation), Rezaul Karim Ripon(Institute for Health Metrics and Evaluation), Simona Sacco(Institute for Health Metrics and Evaluation), Masoumeh Sadeghi(Institute for Health Metrics and Evaluation), Umar Saeed(Institute for Health Metrics and Evaluation), Amirhossein Sahebkar(Institute for Health Metrics and Evaluation), Biniyam Sahiledengle(Institute for Health Metrics and Evaluation), Harihar Sahoo(Institute for Health Metrics and Evaluation), Maitreyi Sahu(Institute for Health Metrics and Evaluation), Joseph S Salama(Institute for Health Metrics and Evaluation), Payman Salamati(Institute for Health Metrics and Evaluation), Abdallah M Samy(Institute for Health Metrics and Evaluation), Juan Sanabria(Institute for Health Metrics and Evaluation), Milena M Santric-Milicevic(Institute for Health Metrics and Evaluation), Brijesh Sathian(Institute for Health Metrics and Evaluation), Monika Sawhney(Institute for Health Metrics and Evaluation), María Inês Schmidt(Institute for Health Metrics and Evaluation), Abdul-Aziz Seidu(Institute for Health Metrics and Evaluation), Sadaf G Sepanlou(Institute for Health Metrics and Evaluation), Allen Seylani(Institute for Health Metrics and Evaluation), Masood Ali Shaikh(Institute for Health Metrics and Evaluation), Aziz Sheikh(Institute for Health Metrics and Evaluation), Adithi Shetty(Institute for Health Metrics and Evaluation), Mika Shigematsu(Institute for Health Metrics and Evaluation), Rahman Shiri(Institute for Health Metrics and Evaluation), K. M. Shivakumar(Institute for Health Metrics and Evaluation), Azad Shokri(Institute for Health Metrics and Evaluation), Jasvinder A. Singh(Institute for Health Metrics and Evaluation), Dhirendra Narain Sinha(Institute for Health Metrics and Evaluation), Valentin Yurievich Skryabin(Institute for Health Metrics and Evaluation), Anna Aleksandrovna Skryabina(Institute for Health Metrics and Evaluation), Ahmad Sofi‐Mahmudi(Institute for Health Metrics and Evaluation), Raúl A. R. C. Sousa(Institute for Health Metrics and Evaluation), Jacqueline H. Stephens(Institute for Health Metrics and Evaluation), Jing Sun(Institute for Health Metrics and Evaluation), Miklós Szócska(Institute for Health Metrics and Evaluation), Rafael Tabarés‐Seisdedos(Institute for Health Metrics and Evaluation), Hooman Tadbiri(Institute for Health Metrics and Evaluation), Animut Tagele Tamiru, Kavumpurathu Raman Thankappan(Institute for Health Metrics and Evaluation), Roman Topór-Mądry(Institute for Health Metrics and Evaluation), Marcos Roberto Tovani‐Palone(Institute for Health Metrics and Evaluation), Mai Thi Ngoc Tran(Institute for Health Metrics and Evaluation), Bach Xuan Tran(Institute for Health Metrics and Evaluation), Niharika Tripathi(Institute for Health Metrics and Evaluation), Jaya Prasad Tripathy(Institute for Health Metrics and Evaluation), Christopher Troeger(Institute for Health Metrics and Evaluation), Deinzel R. Uezono(Institute for Health Metrics and Evaluation), Saif Ullah(Institute for Health Metrics and Evaluation), Anayat Ullah(Institute for Health Metrics and Evaluation), Bhaskaran Unnikrishnan(Institute for Health Metrics and Evaluation), Marco Vacante(Institute for Health Metrics and Evaluation), Sahel Valadan Tahbaz(Institute for Health Metrics and Evaluation), Pascual Valdéz(Institute for Health Metrics and Evaluation), Milena Vasić(Institute for Health Metrics and Evaluation), Massimiliano Veroux(Institute for Health Metrics and Evaluation), Dominique Vervoort(Institute for Health Metrics and Evaluation), Francesco Saverio Violante(Institute for Health Metrics and Evaluation), Sergey Konstantinovitch Vladimirov(Institute for Health Metrics and Evaluation), Vasily Vlassov(Institute for Health Metrics and Evaluation), Bay Vo(Institute for Health Metrics and Evaluation), Yasir Waheed(Institute for Health Metrics and Evaluation), Richard G. Wamai(Institute for Health Metrics and Evaluation), Yuan‐Pang Wang(Institute for Health Metrics and Evaluation), Yanzhong Wang(Institute for Health Metrics and Evaluation), Paul Ward(Institute for Health Metrics and Evaluation), Taweewat Wiangkham(Institute for Health Metrics and Evaluation), Lalit Yadav(Institute for Health Metrics and Evaluation), Seyed Hossein Yahyazadeh Jabbari, Kazumasa Yamagishi(Institute for Health Metrics and Evaluation), Sanni Yaya(Institute for Health Metrics and Evaluation), Vahid Yazdi‐Feyzabadi(Institute for Health Metrics and Evaluation), Siyan Yi(Institute for Health Metrics and Evaluation), Vahit Yiğit(Institute for Health Metrics and Evaluation), Naohiro Yonemoto(Institute for Health Metrics and Evaluation), Mustafa Z Younis(Institute for Health Metrics and Evaluation), Chuanhua Yu(Institute for Health Metrics and Evaluation), Ismaeel Yunusa(Institute for Health Metrics and Evaluation), Sojib Bin Zaman(Institute for Health Metrics and Evaluation), Михаил Сергеевич Застрожин(Institute for Health Metrics and Evaluation), Zhi-Jiang Zhang(Institute for Health Metrics and Evaluation), Chenwen Zhong(Institute for Health Metrics and Evaluation), Yves Miel H Zuñiga(Institute for Health Metrics and Evaluation), Stephen S Lim(Institute for Health Metrics and Evaluation), Christopher J L Murray(Institute for Health Metrics and Evaluation), Rafael Lozano(Institute for Health Metrics and Evaluation)
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Abstract
BACKGROUND: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. METHODS: We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. FINDINGS: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9-21·3), as well as among the young (22·5, 19·9-24·7), working (17·2, 15·2-19·1), and post-working (15·1, 13·2-17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6-33·0) on average in low-SDI countries to 83·4 (82·4-84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4-89·0), working (33·8-82·8), and post-working (30·4-79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. INTERPRETATION: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. FUNDING: Bill & Melinda Gates Foundation.
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