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1.上海市公共卫生临床中心,肾内科,上海
2.上海市公共卫生临床中心,结核科,上海
杨青梅,E-mail:qmyang14@fudan.edu.cn
收稿:2025-12-01,
修回:2026-01-12,
录用:2026-01-16,
纸质出版:2026-02-28
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李琼琼,叶丹,杨青梅.面向精准防控:基于GBD数据对中国医疗不良反应疾病负担趋势及老年男性高风险群体的识别[J].陆军军医大学学报,2026,48(04):514-522.DOI:10.16016/j.2097-0927.202512003.
LI Q Q,YE D,YANG Q M.Toward pecision-based prevention: trends in the burden of adverse effects of medical treatment in China based on GBD data and identification of high-risk elderly male groups[J].J Army Med Univ,2026,48(04):514-522.DOI:10.16016/j.2097-0927.202512003.
李琼琼,叶丹,杨青梅.面向精准防控:基于GBD数据对中国医疗不良反应疾病负担趋势及老年男性高风险群体的识别[J].陆军军医大学学报,2026,48(04):514-522.DOI:10.16016/j.2097-0927.202512003. DOI:
LI Q Q,YE D,YANG Q M.Toward pecision-based prevention: trends in the burden of adverse effects of medical treatment in China based on GBD data and identification of high-risk elderly male groups[J].J Army Med Univ,2026,48(04):514-522.DOI:10.16016/j.2097-0927.202512003. DOI:
目的
2
基于全球疾病负担(Global Burden of Disease,GBD)2023年开放数据,分析1990—2023年我国医疗不良反应(adverse effects of medical treatment,AEMT)负担状况和变化趋势。
方法
2
本研究基于GBD 2023数据,提取1990—2023年我国AEMT的发病数、患病数、伤残调整生命年数(disability-adjusted life years,DALYs)及死亡数,同时提取年龄标化发病率(age-standardized incidence rate,ASIR)、年龄标化患病率(age-standardized prevalence rate,ASPR)、年龄标化伤残调整生命年率(age-standardized disability-adjusted life year rate,ASDR)和年龄标化死亡率(age-standardized mortality rate,ASMR)等数据。计算ASIR、ASPR、ASDR及ASMR的年度变化百分比(annual percent change,APC)、平均年度变化百分比(average annual percent change,AAPC)及其95% 可信区间(95% confidence interval,95%
CI
),以分析国内AEMT疾病负担趋势。比较 1990、2020 及 2023 年我国不同年龄与性别群体中AEMT疾病负担的流行病学特征与差异。
结果
2
1990—2023年,我国AEMT的发病、患病、DALYs 数和死亡数分别由432 784(95%
UI
:347 489~526 244)、33 087(95%
UI
:24 103~42 381)、686 404(95%
UI
:398 451~1 086 894)、11 426(95%
UI
: 7 233~17 456)变化至2020年的342 349(95%
UI
: 279 429~423 443)、26 165(95%
UI
:19 529~33 662)、121 245(95%
UI
:90 707~155 623)、3 337(95%
UI
:2 494~4 212),2023年的372 069(95%
UI
:303 152~464 618)、28 436(95%
UI
:21 029~36 643)、107 384(95%
UI
:79 527~137 417)、3 128(95%
UI
:2 305~3 985)。1990—2023年间,ASIR、ASPR、ASDR、ASMR 的AAPC值分别为-0.994 8% (95%
CI
:-1.199 7%~-0.789 5%)、-0.993 3%(95%
CI
:-1.202 2%~-0.783 9%)、-5.968 4% (95%
CI
:-6.195 9%~-5.740 3%)、-5.432 2 (95%
CI
:-5.658 8%~-5.205 1%)(
P
<
0.05)。1990年我国低年龄组的发病率、死亡率均较高,女性高于男性,高龄组男性高于女性。2020 年及2023年低年龄组女性发病率高于男性、高龄男性发病率高于女性,多数年龄段间同年份、同
年龄段中男性和女性之间发病率的差值较1990年的有所缩小,高龄男性死亡率均高于同时期的女性。
结论
2
1990—2023年我国AEMT疾病负担指标发病、患病、DALYs和死亡情况整体呈现下降趋势。在老年群体中,AEMT发病率及死亡率随年龄增长而增加,而且老年男性更容易死于 AEMT。对策 加大医疗培训和资源投入,提升诊断、治疗AEMT能力,持续加强AEMT防控,针对老年人,尤其是老年男性实施精准干预。
Objective
2
To analyze the status and trends of the burden of adverse effects of medical treatment (AEMT) in China from 1990 to 2023 using open data from the Global Burden of Disease (GBD) 2023.
Methods
2
Based on the GBD 2023 data
we extracted the number of incident cases
prevalent cases
disability-adjusted life years (DALYs)
and deaths due to AEMT in China from 1990 to 2023. We also extracted age-standardized rates
including the age-standardized incidence rate (ASIR)
age-standardized prevalence rate (ASPR)
age-standardized DALYs rate (ASDR)
and age-standardized mortality rate (ASMR). The annual percent change (APC)
average annual percent change (AAPC)
and their 95% confidence intervals (95%
CI
) for ASIR
ASPR
ASDR
and ASMR were calculated to analyze trends in the burden of AEMT in China. Epidemiological characteristics and differences in the AEMT burden among different age and sex groups in China were compared for the years 1990
2020
and 2023.
Results
2
From 1990 to 2023
the number of incident cases
prevalent cases
DALYs
and deaths due to AEMT in China changed from 432 784 (95%
UI
:347 489 to 526 244)
33 087 (95%
UI
: 24 103 to 42 381)
686 404(95%
UI
:398 451 to 1 086 894)
and 11 426(95%
UI
:7 233 to 17 456) to 342 349(95%
UI
: 279 429 to 423 443)
26 165(95%
UI
: 19 529 to 33 662)
121 245(95%
UI
: 90 707 to 155 623)
and 3 337(95%
UI
: 2 494 to 4 212) in 2020
and further to 372 069 (95%
UI
: 303 152 to 464 618)
28 436 (95%
UI
: 21 029 to 36 6
43)
107 384(95%
UI
79 527 to 137 417)
and 3 128 (95%
UI
: 2 305 to 3 985) in 2023. From 1990 to 2023
the AAPC values for ASIR
ASPR
ASDR
and ASMR were -0.994 8%(95%
CI
: -1.199 7% to -0.789 5%)
-0.993 3%(95%
CI
: -1.202 2% to -0.783 9%)
-5.968 4%(95%
CI
: -6.195 9% to -5.740 3%)
and -5.432 2% (95%
CI
: -5.658 8% to -5.205 1%)
respectively
(P
<
0.05). In 1990
incidence and mortality rates were higher in younger age groups and among females compared to males
while rates were higher among older males compared to older females. In 2020 and 2023
incidence was higher among females than males in younger age groups and higher among older males than older females; the differences in incidence rates between males and females within the same age group and year narrowed compared to 1990
while mortality among older males remained higher than among females in the same periods. Conclusion From 1990 to 2023
key indicators of the AEMT burden in China-incidence
prevalence
DALYs
and mortality-showed an overall declining trend. Among the elderly population
AEMT incidence and mortality increased with age
and elderly males were more likely to die from AEMT than elderly women. Countermeasures Enhancing investment in medical training and resources to improve the capability for diagnosing and treating AEMT
continuously strengthening AEMT prevention and control
and implementing tailored interventions for the elderly
particularly elderly males.
SCHWENDIMANN R , BLATTER C , DHAINI S , et al . The occurrence, types, consequences and preventability of in-hospital adverse events—a scoping review [J]. BMC Health Serv Res , 2018 , 18 ( 1 ): 521 . DOI: 10.1 http://dx.doi.org/10.1 ,186/s12913-018-3335-z.
BRENNAN T A , LEAPE L L , LAIRD N M , et al . Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. 1991 [J]. Qual Saf Health Care , 2004 , 13 ( 2 ): 145-151;discussion151-2 . DOI: 10.1 http://dx.doi.org/10.1 ,136/qshc.2002. 003822 .
Institute of Medicine Committee on Quality of Health Care in America) . To err is human: building a safer health system [M]. Washington DC : National Academies Press (US) , 2000 . DOI: 10.17226/9728 http://dx.doi.org/10.17226/9728
LIN L . Global, regional and national time trends in incidence of adverse effects of medical treatment, 1990—2019: an age-period-cohort analysis from the Global Burden of Disease 2019 Study [J]. BMJ Quality & Safety , 2024 . DOI: 10.1136/bmjqs-2023-016971 http://dx.doi.org/10.1136/bmjqs-2023-016971 .
KAMATH A , ACHARYA SD , BHARATHI RP . Burden of death and disability due to adverse effects of medical treatment in India: an analysis using the global burden of disease 2019 study data [J]. Heliyon , 2024 , 10 ( 2 ): e24924 . DOI: 10.1 http://dx.doi.org/10.1 ,016/j.heliyon.2024.e24924.
KONG X , TAO X F , LI L , et al . Global trends and partial forecast of adverse effects of medical treatment from 1990 to 2019: an epidemiological analysis based on the global burden of disease study 2019 [J]. BMC Public Health , 2024 , 24 ( 1 ): 295 . DOI: 10.1186/s12889-023-17560-0 http://dx.doi.org/10.1186/s12889-023-17560-0 .
RODZIEWICZ T L , HOUSEMEN B , VAQAR S , HIPSKIND J E . Medical error reduction and prevention [DB/OL]. Treasure Island (FL): StatPearls Publishing , 2024-02-12 [ 2024-07-19 ]. https://www.ncbi.nlm.nih.gov/books/NBK499956/ https://www.ncbi.nlm.nih.gov/books/NBK499956/
KAMATH A , ACHARYA S D , BHARATHI R P . Burden of death and disability due to adverse effects of medical treatment in India: an analysis using the global burden of disease 2019 study data [J]. Heliyon , 2024 , 10 ( 2 ): e24924 . DOI: 10.1 http://dx.doi.org/10.1 ,016/j.heliyon.2024.e 24 , 924 .
WEI X M , JIANG L , ZHANG Z D , et al . Temporal trends in the incidence of adverse effects of medical treatment in BRICS countries from 1990 to 2021: an age-period cohort analysis [J]. Front Public Health , 2025 , 13: 1508 , 272 . DOI: 10.3389/fpubh.2025.1508272 http://dx.doi.org/10.3389/fpubh.2025.1508272 .
中华人民共和国国家卫生健康委员会 . 我国卫生健康事业发展统计公报(第 9 - 10 期)[EB/OL]. ( 2025-12 ) [ 2026-01-2 7 11: 36 ]. https://www.nhc.gov.cn/bgt/c100276c/202512/94ac08ac83134f568818ce3c9be5d0fc.shtml https://www.nhc.gov.cn/bgt/c100276c/202512/94ac08ac83134f568818ce3c9be5d0fc.shtml
National Health Commission of the People’s Republic of China . Statistical Bulletin on the Development of Health Undertakings in China (Issues 9 - 10 ) [EB/OL]. ( 2025-12 ) [ 2026-01-2 7 11: 36 ]. Available from : https://www.nhc.gov.cn/bgt/c100276c/202512/94ac08ac83134f568818ce3c9be5d0fc.shtml https://www.nhc.gov.cn/bgt/c100276c/202512/94ac08ac83134f568818ce3c9be5d0fc.shtml
GBD 2023 Headache Collaborators . Global, regional, and national burden of headache disorders, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023 [J]. Lancet Neurol , 2025 , 24 ( 12 ): 1005 - 1015 . DOI: 10.1 http://dx.doi.org/10.1 ,016/S1474-4422( 25)00402 - 8 .
ZOMAWIA E , ZAMI Z , VANLALLAWMA A , et al . Cancer awareness, diagnosis and treatment needs in Mizoram, India: evidence from 18 years trends (2003-2020) [J]. Lancet Reg Health Southeast Asia , 2023 , 17 : 100281 . DOI: 10.1 http://dx.doi.org/10.1 ,016/j.lansea.2023. 100 , 281 .
LUO Z , HE Y , MA G F , et al . Years of life lost due to premature death and their trends in people with malignant neoplasm of female genital organs in Shanghai, China during 1995-2018: a population based study [J]. BMC Public Health , 2020 , 20 ( 1 ): 1489 . DOI: 10.1186/s12889-020-09593-6 http://dx.doi.org/10.1186/s12889-020-09593-6 .
NAUMAN J , SOTERIADES E S , HASHIM M J , et al . Global incidence and mortality trends due to adverse effects of medical treatment, 1990-2017: a systematic analysis from the global burden of diseases, injuries and risk factors study [J]. Cureus , 2020 , 12 ( 3 ): e7265 . DOI: 10.7759/cureus.7265 http://dx.doi.org/10.7759/cureus.7265 .
AHMED A M , THOMPSON L A . The burden of paediatric adverse medical events [J]. Paediatr Perinat Epidemiol , 2024 , 38 ( 8 ): 700 - 702 . DOI: 10.1 http://dx.doi.org/10.1 ,111/ppe. 13 , 127 .
EPSTEIN R J . To find fault is easy, to find no-fault is fair [J]. Future Healthc J , 2023 , 10 ( 1 ): 85 - 89 . DOI: 10.7 http://dx.doi.org/10.7 ,861/fhj. 2022 - 0049 .
MOR N . Lessons for developing countries from outlier country health systems [J]. Front Public Health , 2022 , 10 : 870210 . DOI: 10.3 http://dx.doi.org/10.3 ,389/fpubh.2022. 870210 .
国家卫生和计划生育委员会 . 医疗质量管理办法 [EB/OL].( 2017 ) [ 2026-01-2 7 1: 39 ]. https://www.gov.cn/gongbao/content/2017/content_5225870.htm https://www.gov.cn/gongbao/content/2017/content_5225870.htm
National Health and Family Planning Commission of the People’s Republic of China . Medical quality management measures [EB/OL]. ( 2017 ) [ 2026-01-2 7 11: 39 ]. Available from : https://www.gov.cn/gongbao/content/2017/content_5225870.htm https://www.gov.cn/gongbao/content/2017/content_5225870.htm
中华人民共和国国家卫生健康委员会 . 患者安全专项行动方案(2023-2025) [EB/OL]. ( 2023-10 ) [ 2026-01-2 7 11: 44 ]. https://www.nhc.gov.cn/yzygj/c100068/202310/f9d 6752a3b8640d2a62661497b4394f6.shtml https://www.nhc.gov.cn/yzygj/c100068/202310/f9d6752a3b8640d2a62661497b4394f6.shtml
National Health Commission of the People’s Republic of China . Patient safety special action plan ( 2023-2025 ) [EB/OL]. ( 2023-10 ) [ 2026-01-2 7 11: 44 ]. Available from : https://www.nhc.gov.cn/yzygj/c100068/202310/f9d6752a3b8640d2a62661497b4394f6.shtml https://www.nhc.gov.cn/yzygj/c100068/202310/f9d6752a3b8640d2a62661497b4394f6.shtml
WU F , ZHAO S , YU B , et al . A new coronavirus associated with human respiratory disease in China [J]. Nature , 2020 , 579 ( 7798 ): 265 - 269 . DOI: 10.1038/s41586-020-2008-3 http://dx.doi.org/10.1038/s41586-020-2008-3 .
ZHOU P , YANG X L , WANG X G , et al . A pneumonia outbreak associated with a new coronavirus of probable bat origin [J]. Nature , 2 020579 ( 7798 ): 270 - 273 . DOI: 10.1038/s41586-020-2012-7 http://dx.doi.org/10.1038/s41586-020-2012-7 .
中华人民共和国中央人民政府 . 关于印发对新型冠状病毒感染实施“乙类乙管”总体方案的通知 [EB/OL]. ( 2022-12-26 ) [ 2026-01-16 ]. https://www.gov.cn/xinwen/2022-12/27/content_5733739.htm https://www.gov.cn/xinwen/2022-12/27/content_5733739.htm
The State Council of the People's Republic of China . Notice on issuing the overall plan for implementing class B management of COVID-19 Infection [EB/OL]. ( 2022-12-26 ) [ 2026-01-16 ]. Available from Availablefrom : https://www.gov.cn/xinwen/2022-12/27/content_5733739.htm https://www.gov.cn/xinwen/2022-12/27/content_5733739.htm
JI X W , MENG X R , ZHU X , et al . Research and development of Chinese anti-COVID-19 drugs [J]. Acta Pharm Sin B , 2022 , 12 ( 12 ): 4271 - 4286 . DOI: 10.1016/j.apsb.2022.09.002 http://dx.doi.org/10.1016/j.apsb.2022.09.002 .
ZANG J X , JIANG L F , WANG Y Y , et al . Impact of easing COVID-19 restrictions on antibiotic usage in Eastern China using wastewater-based epidemiology [J]. Nat Commun , 2024 , 15 ( 1 ): 10161 . DOI: 10.1038/s41467-024-54498-2 http://dx.doi.org/10.1038/s41467-024-54498-2 .
LIU J , ZHAI X H , YAN W X , et al . Long-term impact of the COVID-19 pandemic on health services utilization in China: a nationwide longitudinal study [J]. Glob Transit , 2023 , 5 : 21 - 28 . DOI: 10.1 http://dx.doi.org/10.1 ,016/j.glt.2023.03.002.
KAUSHAL R , BATES D W , LANDRIGAN C , et al . Medication errors and adverse drug events in pediatric inpatients [J]. JAMA , 2001 , 285 ( 16 ): 2114 - 2120 . DOI: 10.1001/jama.285.16.2114 http://dx.doi.org/10.1001/jama.285.16.2114 .
SUNSHINE J E , MEO N , KASSEBAUM N J , et al . Association of adverse effects of medical treatment with mortality in the United States: a secondary analysis of the global burden of diseases, injuries, and risk factors study [J]. JAMA Netw Open , 2019 , 2 ( 1 ): e187041 . DOI: 10.1 http://dx.doi.org/10.1 ,001/jamanetworkopen. 2018 . 7041 .
SHIN E , LEIBOVITCH E , NISHIMURA Y , et al . Long-term trends in mortality from adverse effects of medical treatment in older populations in the United States from 1990 to 2019 [J]. J Am Pharm Assoc , 2024 , 64 ( 1 ): 55 - 61 . DOI: 10.1 http://dx.doi.org/10.1 ,016/j.japh.2023.09.007.
MAUVAIS-JARVIS F , BAIREY MERZ N , BARNES P J , et al . Sex and gender: modifiers of health, disease, and medicine [J]. Lancet , 2020 , 396 ( 10250 ): 565 - 582 . DOI: 10.1016/S0140-6736(20)31561-0 http://dx.doi.org/10.1016/S0140-6736(20)31561-0 .
ZHAO E F , CRIMMINS E M . Mortality and morbidity in ageing men: biology, lifestyle and environment [J]. Rev Endocr Metab Disord , 2022 , 23 ( 6 ): 1285 - 1304 . DOI: 10.1007/s11154-022-09737-6 http://dx.doi.org/10.1007/s11154-022-09737-6 .
ROGERS R G , EVERETT B G , SAINT ONGE J M , et al . Social, behavioral, and biological factors, and sex differences in mortality [J]. Demography , 2010 , 47 ( 3 ): 555 - 578 . DOI: 10.1353/dem.0.0119 http://dx.doi.org/10.1353/dem.0.0119 .
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