The Association between Health System Development and the Burden of Cardiovascular Disease: An Analysis of WHO Country Profiles

Abstract

BackgroundSeveral risk factors for cardiovascular disease (CVD) have been identified in recent decades. However, the association between the health system and the burden of CVD has not yet been sufficiently researched. The objective of this study was to analyse the association between health system development and the burden of CVD, in particular CVD-related disability-adjusted life–years (DALYs).MethodsUnivariate and multivariate generalized linear mixed models were applied to country-level data collected by the World Bank and World Health Organization. Response variables were the age-standardized CVD mortality and age-standardized CVD DALY rates.ResultsThe amount of available health system resources, indicated by total health expenditures per capita, physician density, nurse density, dentistry density, pharmaceutical density and the density of hospital beds, was associated with reduced CVD DALY rates and CVD mortality. However, in the multivariate models, the density of nurses and midwives was positively associated with CVD. High out-of-pocket costs were associated with increased CVD mortality in both univariate and multivariate analyses.ConclusionA highly developed health system with a low level of out-of-pocket costs seems to be the most appropriate to reduce the burden of CVD. Furthermore, an efficient balance between human health resources and health technologies is essential.

Hypertension Treatment Rates and Health Care Worker Density

“…An analysis of the relationship between health care worker density (including physicians, nurses, and others) and CVD outcomes reported that a univariate analysis revealed that health care worker density is associated with better CVD outcomes, although a multivariable analysis yielded the opposite relationship. 18 Another study reported no significant relationship between physician density and medical guideline adherence (including for CVD) in Germany. 19 Current estimates of global health care worker shortages have largely not taken into account the human resource requirements for managing NCDs.…”

Cardiovascular Diseases in the Context of Russia’s Long-Term Socio-Economic Development Priorities

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Cardiovascular and autoimmune diseases in females: The role of microvasculature and dysfunctional endothelium

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