Integrated prevention and management of non-communicable diseases, including musculoskeletal health: a systematic policy analysis among OECD countries

Integrated prevention and management of non-communicable diseases, including musculoskeletal health: a systematic policy analysis among OECD countries

IntroductionDevelopment and implementation of appropriate health policy is essential to address the rising global burden of non-communicable diseases (NCDs). The aim of this study was to evaluate existing health policies for integrated prevention/management of NCDs among Member States of the Organis...

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Published in:BMJ global health Vol. 4; no. 5; p. e001806
Main Authors: Briggs, Andrew M, Persaud, Jennifer G, Deverell, Marie L, Bunzli, Samantha, Tampin, Brigitte, Sumi, Yuka, Amundsen, Olav, Houlding, Elizabeth MG, Cardone, Anontella, Hugosdottir, Thora, Rogers, Sophia, Pozsgai, Miklós, Slater, Helen
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 01-09-2019
BMJ Publishing Group
Subjects:
Aging
Cardiovascular diseases
Disease prevention
Global health
Health policy
Infectious diseases
Low income groups
Morbidity
Mortality
Pain
Prevention
Risk factors
Sustainable development
New Zealand
Greece
Austria
Turkey
Luxembourg
Finland
global
musculoskeletal
integrated care
health system
non-communicable
policy
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Summary:IntroductionDevelopment and implementation of appropriate health policy is essential to address the rising global burden of non-communicable diseases (NCDs). The aim of this study was to evaluate existing health policies for integrated prevention/management of NCDs among Member States of the Organisation for Economic Co-operation and Development (OECD). We sought to describe policies’ aims and strategies to achieve those aims, and evaluate extent of integration of musculoskeletal conditions as a leading cause of global morbidity.MethodsPolicies submitted by OECD Member States in response to a World Health Organization (WHO) NCD Capacity Survey were extracted from the WHO document clearing-house and analysed following a standard protocol. Policies were eligible for inclusion when they described an integrated approach to prevention/management of NCDs. Internal validity was evaluated using a standard instrument (sum score: 0–14; higher scores indicate better quality). Quantitative data were expressed as frequencies, while text data were content-analysed and meta-synthesised using standardised methods.ResultsAfter removal of duplicates and screening, 44 policies from 30 OECD Member States were included. Three key themes emerged to describe the general aims of included policies: system strengthening approaches; improved service delivery; and better population health. Whereas the policies of most countries covered cancer (83.3%), cardiovascular disease (76.6%), diabetes/endocrine disorders (76.6%), respiratory conditions (63.3%) and mental health conditions (63.3%), only half the countries included musculoskeletal health and pain (50.0%) as explicit foci. General strategies were outlined in 42 (95.5%) policies—all were relevant to musculoskeletal health in 12 policies, some relevant in 27 policies and none relevant in three policies. Three key themes described the strategies: general principles for people-centred NCD prevention/management; enhanced service delivery; and system strengthening approaches. Internal validity sum scores ranged from 0 to 13; mean: 7.6 (95% CI 6.5 to 8.7).ConclusionRelative to other NCDs, musculoskeletal health did not feature as prominently, although many general prevention/management strategies were relevant to musculoskeletal health improvement.
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ISSN:2059-7908
2059-7908
DOI:10.1136/bmjgh-2019-001806