Background: Multiple sclerosis (MS) is a common neurologic autoimmune disorder. We have used a newly introduced measure, Quality of Care Index (QCI), which is associated with the efficacy of care given to patients suffering from MS. Objectives: The aims of the study were to report and compare the quality of care given to MS patients in different regions and country. Methods: Primary measures were retrieved from Global Burden of Disease (GBD) from 1990 to 2019. Secondary measures (mortality-to-incidence ratio, DALY-to-prevalence ratio, prevalence-to-incidence ratio, and YLL-to-YLD ratio) were combined using principal component analysis, to form an essential component (QCI) (0–100 index with higher values representing better condition). Results: In 2019, there were 59,345 (95% UI: 51,818–66,943) new MS incident cases globally. Global QCI of 88.4 was calculated for 2019. At national level, Qatar had the highest quality of care (100) followed by Kuwait (98.5) and Greenland (98.1). The lowest QCI was observed in Kiribati (13.5), Nauru (31.5), and Seychelles (36.3), respectively. Most countries have reached gender equity during the 30 years. Also, QCI was lowest in ages from 55 to 80 in global scale. Conclusion: MS QCI is better among those countries of higher socioeconomic status, possibly due to better healthcare access and early detection in these regions. Countries could benefit from adopting the introduced QCI to evaluate the quality of care given to MS patients at national and global level.

Journal Section:
Original Paper
Keywords:
Multiple sclerosis, Global Burden of Disease, Principal component analysis, Quality of Care Index
1.
Reich DS, Lucchinetti CF, Calabresi PA. Multiple sclerosis. N Engl J Med. 2018;378(2):169–80.
https://doi.org/10.1056/NEJMra1401483
2.
Compston A, Coles A. Multiple sclerosis. Lancet. 2008;372(9648):1502–17.
https://doi.org/10.1016/S0140-6736(08)61620-7
3.
GBD 2016 Multiple Sclerosis Collaborators. Global, regional, and national burden of multiple sclerosis 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(3):269–85.
https://doi.org/10.1016/S1474-4422(18)30443-5
4.
GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020;396(10258):1204–22.
https://doi.org/10.1016/S0140-6736(20)30925-9
5.
Pekic S, Stojanovic M, Popovic V. Controversies in the risk of neoplasia in GH deficiency. Best Pract Res Clin Endocrinol Metab. 2017;31(1):35–47.
https://doi.org/10.1016/j.beem.2017.02.004
6.
Mohammadi E, Ghasemi E, Azadnajafabad S, Rezaei N, Saeedi Moghaddam S, Ebrahimi Meimand S, et al. A global, regional, and national survey on burden and Quality of Care Index (QCI) of brain and other central nervous system cancers; global burden of disease systematic analysis 1990-2017. PLoS One. 2021;16(2):e0247120.
https://doi.org/10.1371/journal.pone.0247120
7.
Mohammadi E, Ghasemi E, Saeedi Moghaddam S, Yoosefi M, Ghanbari A, Ahmadi N, et al. Quality of care index (QCI). Protocols.io; 2020. Available from: https://dx.doi.org/10.17504/protocols.io.bprjmm4n.
8.
Moore KA, Vandivere S, Redd Z. A sociodemographic risk index. Soc Indic Res. 2006;75(1):45–81.
https://doi.org/10.1007/s11205-004-6398-7
9.
Zhao YB, Gan XQ, Luo P, He Q, Guo QD, Zhang L, et al. The risk of osteopenia in premenopausal women with various sellar tumors. Gynecol Endocrinol. 2012;28(12):945–8.
https://doi.org/10.3109/09513590.2012.683080
10.
Furgal-Borzych A, Lis GJ, Litwin JA, Rzepecka-Wozniak E, Trela F, Cichocki T. Increased incidence of pituitary microadenomas in suicide victims. Neuropsychobiology. 2007;55(3–4):163–6.
https://doi.org/10.1159/000106475
11.
Świątkowska-Stodulska R, Babińska A, Mital A, Stodulski D, Sworczak K. Hemostatic disorders in hormonally active pituitary tumors. Exp Clin Endocrinol Diabetes. 2015;123(9):548–52.
https://doi.org/10.1055/s-0035-1555889
12.
GBD 2019 Universal Health Coverage Collaborators. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1250–84.
https://doi.org/10.1016/S0140-6736(20)30750-9
13.
Westlund K. Distribution and mortality time trend of multiple sclerosis and some other diseases in Norway. Acta Neurol Scand. 1970;46(4):455–83.
https://doi.org/10.1111/j.1600-0404.1970.tb05806.x
14.
Sahraian MA, Sahebkar M, Dehghani R, Derakhshan-Jazari M, Kazami-Moghaddam V, Kouchaki E. Multiple sclerosis-a disease on a dramatically rising trend in iran: review of possible reasons. Iran J Neurol. 2017;16(1):34–40.
15.
Noonan CW, Kathman SJ, White MC. Prevalence estimates for MS in the United States and evidence of an increasing trend for women. Neurology. 2002;58(1):136–8.
https://doi.org/10.1212/wnl.58.1.136
16.
Cutter GR, Koch MW. Multiple sclerosis diagnostic criteria. Moving ahead or walking in place?Neurology. 2022;98(1):12–3.
https://doi.org/10.1212/WNL.0000000000013014
17.
Liu Z, Liao Q, Wen H, Zhang Y. Disease modifying therapies in relapsing-remitting multiple sclerosis: a systematic review and network meta-analysis. Autoimmun Rev. 2021;20(6):102826.
https://doi.org/10.1016/j.autrev.2021.102826
18.
Azadnajafabad S, Saeedi Moghaddam S, Mohammadi E, Rezaei N, Ghasemi E, Fattahi N, et al. Global, regional, and national burden and quality of care index (QCI) of thyroid cancer: a systematic analysis of the Global Burden of Disease Study 1990-2017. Cancer Med. 2021;10(7):2496–508.
https://doi.org/10.1002/cam4.3823
19.
Adelman G, Rane SG, Villa KF. The cost burden of multiple sclerosis in the United States: a systematic review of the literature. J Med Econ. 2013;16(5):639–47.
https://doi.org/10.3111/13696998.2013.778268
20.
Asche CV, Singer ME, Jhaveri M, Chung H, Miller A. All-cause health care utilization and costs associated with newly diagnosed multiple sclerosis in the United States. J Manag Care Pharm. 2010;16(9):703–12.
https://doi.org/10.18553/jmcp.2010.16.9.703
21.
Prescott JD, Factor S, Pill M, Levi GW. Descriptive analysis of the direct medical costs of multiple sclerosis in 2004 using administrative claims in a large nationwide database. J Manag Care Pharm. 2007;13(1):44–52.
https://doi.org/10.18553/jmcp.2007.13.1.44
22.
Petruzzo M, Palladino R, Nardone A, Nozzolillo A, Servillo G, Orlando V, et al. The impact of diagnostic criteria and treatments on the 20-year costs for treating relapsing-remitting multiple sclerosis. Mult Scler Relat Disord. 2020;38:101514.
https://doi.org/10.1016/j.msard.2019.101514
23.
Aljumah M, Alroughani R, Alsharoqi I, Bohlega SA, Dahdaleh M, Deleu D, et al. Future of management of multiple sclerosis in the middle East: a consensus view from specialists in ten countries. Mult Scler Int. 2013;2013:952321.
https://doi.org/10.1155/2013/952321
24.
Deleu D, Mir D, Al Tabouki A, Mesraoua R, Mesraoua B, Akhtar N, et al. Prevalence, demographics and clinical characteristics of multiple sclerosis in Qatar. Mult Scler. 2013;19(6):816–9.
https://doi.org/10.1177/1352458512459291
25.
Kurtzke JF. Geographic distribution of multiple sclerosis: an update with special reference to Europe and the Mediterranean region. Acta Neurol Scand. 1980;62(2):65–80.
https://doi.org/10.1111/j.1600-0404.1980.tb03006.x
26.
Eskandarieh S, Heydarpour P, Minagar A, Pourmand S, Sahraian MA. Multiple sclerosis epidemiology in east Asia, south east Asia and south Asia: a systematic review. Neuroepidemiology. 2016;46(3):209–21.
https://doi.org/10.1159/000444019
27.
Chong HT. Multiple sclerosis in south east Asia and diagnostic criteria for asians. Neurol Asia. 2008;13(2):145–6.
28.
Aminorroaya A, Yoosefi M, Rezaei N, Shabani M, Mohammadi E, Fattahi N, et al. Global, regional, and national quality of care of ischaemic heart disease from 1990 to 2017: a systematic analysis for the Global Burden of Disease Study. European Journal of Preventive Cardiology; 2017. p. 2021.
29.
Keykhaei M, Masinaei M, Mohammadi E, Azadnajafabad S, Rezaei N, Saeedi Moghaddam S, et al. A global, regional, and national survey on burden and Quality of Care Index (QCI) of hematologic malignancies; global burden of disease systematic analysis 1990–2017. Exp Hematol Oncol. 2021;10(1):11–5.
https://doi.org/10.1186/s40164-021-00198-2
© 2023 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2023
You do not currently have access to this content.