Global burden of adverse effects of medical treatment from 1990 to 2021: a Global Burden of Disease Study 2021

doi:10.3904/kjim.2025.278

Global burden of adverse effects of medical treatment from 1990 to 2021: a Global Burden of Disease Study 2021

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Abstract

Background/Aims: This study aims to evaluate the global burden of adverse effects of medical treatment (AEMT) using data from the Global Burden of Disease Study (GBD) 2021. Methods: Data were extracted from the GBD 2021, covering 204 countries/territories from 1990 to 2021. AEMT was defined using ICD-9 and ICD-10 codes, encompassing complications from medical procedures, treatments, or healthcare exposures. Estimates were categorized into fatal and non-fatal outcomes and stratified by age, sex, year, and covariates, including the Socio-demographic Index (SDI). Mortality-incidence ratios (MIRs), defined as the ratio of mortality calculated by dividing the number of deaths by the total incident cases, were analyzed. Results: In 2021, the global age-standardized 1.53 (1.29-1.68) per 100,000 population, respectively. DALY rates were highest in the early neonatal group (4,789.47 per 100,000 population [95% UI, 3,682.00-5,963.30]), while mortality rates followed a U-shaped pattern across age groups. In 2021, MIRs were highest at both ends of the age range: the early neonatal group (0.58 [95% UI, 0.55-0.58]) and the 95+ age group (0.05 [0.04-0.06]). This pattern was consistent across all SDI quintiles, with higher MIRs observed in lower SDI quintiles. Conclusions: The significantly higher prevalence and incidence rates of AEMT among the older population in high SDI quintiles, compared to lower SDI quintiles, could be attributed to the healthcare overutilization, highlighting the need for policy adjustments.

Original language	English
Pages (from-to)	350-366
Number of pages	17
Journal	Korean Journal of Internal Medicine (KJIM)
Volume	41
Issue number	2
Early online date	1 Mar 2026
DOIs	https://doi.org/10.3904/kjim.2025.278
Publication status	Published (in print/issue) - 30 Mar 2026

Bibliographical note

Data Availability Statement

The findings from this study were produced using data available in public online repositories or in the published literature, data that are publicly available on request from the data provider, and data that are not publicly available due to restrictions by the data provider and which were used under license for the current study. Details on data sources can be found on the GHDx website, including information about the data provider and links to where the data can be accessed or requested (where available). To download the data used in these analyses, please visit the Global Health Data Exchange GBD 2021 website at https://ghdx.healthdata.org/gbd-2021.

Funding

This study was funded by the Gates Foundation, Australian National Health and Medical Research Council, and Queensland Department of Health, Australia. This work was supported by the Yonsei Fellowship, funded by Lee Youn Jae (to JIS). This research was supported by the Ministry of Science and ICT (RS-2024-00509257 and IITP-2024-RS-2024-00438239 to DKY) and the Ministry of Health & Welfare (RS-2025-02220492 to DKY), Republic of Korea. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to the study data and had final responsibility for the decision to submit for publication.

Keywords

Adverse effect
Disability-adjusted life years
Global Burden of Disease
Incidence
Mortality
Disability-Adjusted Life Years
Prevalence
Humans
Middle Aged
Child, Preschool
Male
Infant
Drug-Related Side Effects and Adverse Reactions/mortality
Young Adult
Time Factors
Aged, 80 and over
Female
Adult
Child
Infant, Newborn
Global Health
Risk Factors
Adolescent
Aged
Global Burden of Disease/trends

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@article{0a96c0ac5ee94175981ad04e269dde0d,

title = "Global burden of adverse effects of medical treatment from 1990 to 2021: a Global Burden of Disease Study 2021",

abstract = "Background/Aims: This study aims to evaluate the global burden of adverse effects of medical treatment (AEMT) using data from the Global Burden of Disease Study (GBD) 2021. Methods: Data were extracted from the GBD 2021, covering 204 countries/territories from 1990 to 2021. AEMT was defined using ICD-9 and ICD-10 codes, encompassing complications from medical procedures, treatments, or healthcare exposures. Estimates were categorized into fatal and non-fatal outcomes and stratified by age, sex, year, and covariates, including the Socio-demographic Index (SDI). Mortality-incidence ratios (MIRs), defined as the ratio of mortality calculated by dividing the number of deaths by the total incident cases, were analyzed. Results: In 2021, the global age-standardized 1.53 (1.29-1.68) per 100,000 population, respectively. DALY rates were highest in the early neonatal group (4,789.47 per 100,000 population [95\% UI, 3,682.00-5,963.30]), while mortality rates followed a U-shaped pattern across age groups. In 2021, MIRs were highest at both ends of the age range: the early neonatal group (0.58 [95\% UI, 0.55-0.58]) and the 95+ age group (0.05 [0.04-0.06]). This pattern was consistent across all SDI quintiles, with higher MIRs observed in lower SDI quintiles. Conclusions: The significantly higher prevalence and incidence rates of AEMT among the older population in high SDI quintiles, compared to lower SDI quintiles, could be attributed to the healthcare overutilization, highlighting the need for policy adjustments.",

keywords = "Adverse effect, Disability-adjusted life years, Global Burden of Disease, Incidence, Mortality, Disability-Adjusted Life Years, Prevalence, Humans, Middle Aged, Child, Preschool, Male, Infant, Drug-Related Side Effects and Adverse Reactions/mortality, Young Adult, Time Factors, Aged, 80 and over, Female, Adult, Child, Infant, Newborn, Global Health, Risk Factors, Adolescent, Aged, Global Burden of Disease/trends",

author = "Jeong, \{Yi Deun\} and Seoyoung Park and Wonwoo Jang and Kim, \{Min Seo\} and A. Bhoomadevi and Aalipour, \{Mohammad Amin\} and Ab-Dalla, \{Mohammed Altigani\} and Meriem Abdoun and Auwal Abdullahi and Toufik Abdul-Rahman and Armita Abedi and Aboagye, \{Richard Gyan\} and Mohamed Abouzid and Dariush Abtahi and Bilyaminu Abubakar and Eman Abu-Gharbieh and Abuhelwa, \{Ahmad Y.\} and Salahdein Aburuz and Dina Abushanab and Adams, \{Lisa C.\} and Adedokun, \{Kamoru Ademola\} and Adegoke, \{Nurudeen A.\} and Adeleke, \{Olumide Thomas\} and Adetunji, \{Juliana Bunmi\} and Adeyeoluwa, \{Temitayo Esther\} and Mohd Adnan and Adoma, \{Prince Owusu\} and David Adzrago and Afolabi, \{Habeeb Abiodun\} and Afr{\u a}s{\^a}nie, \{Vlad Adrian\} and Fatemeh Afrashteh and Saira Afzal and Williams Agyemang-Duah and Mahsa Ahadi and Ahinkorah, \{Bright Opoku\} and Aqeel Ahmad and Danish Ahmad and Ahmad, \{Muayyad M.\} and Sajjad Ahmad and Ahmadi, \{Negar Sadat\} and Ali Ahmed and Ayman Ahmed and Ahmed, \{Muktar Beshir\} and Ahmed, \{Sindew Mahmud\} and Yazan Al-Ajlouni and Mostafa Alam and Al-Ashwal, \{Fahmi Y.\} and Aldhaleei, \{Wafa A.\} and Aleidi, \{Shereen M.\} and Elnaem, \{Mohamed Hassan\}",

note = "Copyright {\textcopyright} 2026 The Korean Association of Internal Medicine.",

year = "2026",

month = mar,

day = "30",

doi = "10.3904/kjim.2025.278",

language = "English",

volume = "41",

pages = "350--366",

journal = "Korean Journal of Internal Medicine (KJIM)",

issn = "1226-3303",

number = "2",

}

TY - JOUR

T1 - Global burden of adverse effects of medical treatment from 1990 to 2021

T2 - a Global Burden of Disease Study 2021

AU - Jeong, Yi Deun

AU - Park, Seoyoung

AU - Jang, Wonwoo

AU - Kim, Min Seo

AU - Bhoomadevi, A.

AU - Aalipour, Mohammad Amin

AU - Ab-Dalla, Mohammed Altigani

AU - Abdoun, Meriem

AU - Abdullahi, Auwal

AU - Abdul-Rahman, Toufik

AU - Abedi, Armita

AU - Aboagye, Richard Gyan

AU - Abouzid, Mohamed

AU - Abtahi, Dariush

AU - Abubakar, Bilyaminu

AU - Abu-Gharbieh, Eman

AU - Abuhelwa, Ahmad Y.

AU - Aburuz, Salahdein

AU - Abushanab, Dina

AU - Adams, Lisa C.

AU - Adedokun, Kamoru Ademola

AU - Adegoke, Nurudeen A.

AU - Adeleke, Olumide Thomas

AU - Adetunji, Juliana Bunmi

AU - Adeyeoluwa, Temitayo Esther

AU - Adnan, Mohd

AU - Adoma, Prince Owusu

AU - Adzrago, David

AU - Afolabi, Habeeb Abiodun

AU - Afrăsânie, Vlad Adrian

AU - Afrashteh, Fatemeh

AU - Afzal, Saira

AU - Agyemang-Duah, Williams

AU - Ahadi, Mahsa

AU - Ahinkorah, Bright Opoku

AU - Ahmad, Aqeel

AU - Ahmad, Danish

AU - Ahmad, Muayyad M.

AU - Ahmad, Sajjad

AU - Ahmadi, Negar Sadat

AU - Ahmed, Ali

AU - Ahmed, Ayman

AU - Ahmed, Muktar Beshir

AU - Ahmed, Sindew Mahmud

AU - Al-Ajlouni, Yazan

AU - Alam, Mostafa

AU - Al-Ashwal, Fahmi Y.

AU - Aldhaleei, Wafa A.

AU - Aleidi, Shereen M.

AU - Elnaem, Mohamed Hassan

PY - 2026/3/30

Y1 - 2026/3/30

N2 - Background/Aims: This study aims to evaluate the global burden of adverse effects of medical treatment (AEMT) using data from the Global Burden of Disease Study (GBD) 2021. Methods: Data were extracted from the GBD 2021, covering 204 countries/territories from 1990 to 2021. AEMT was defined using ICD-9 and ICD-10 codes, encompassing complications from medical procedures, treatments, or healthcare exposures. Estimates were categorized into fatal and non-fatal outcomes and stratified by age, sex, year, and covariates, including the Socio-demographic Index (SDI). Mortality-incidence ratios (MIRs), defined as the ratio of mortality calculated by dividing the number of deaths by the total incident cases, were analyzed. Results: In 2021, the global age-standardized 1.53 (1.29-1.68) per 100,000 population, respectively. DALY rates were highest in the early neonatal group (4,789.47 per 100,000 population [95% UI, 3,682.00-5,963.30]), while mortality rates followed a U-shaped pattern across age groups. In 2021, MIRs were highest at both ends of the age range: the early neonatal group (0.58 [95% UI, 0.55-0.58]) and the 95+ age group (0.05 [0.04-0.06]). This pattern was consistent across all SDI quintiles, with higher MIRs observed in lower SDI quintiles. Conclusions: The significantly higher prevalence and incidence rates of AEMT among the older population in high SDI quintiles, compared to lower SDI quintiles, could be attributed to the healthcare overutilization, highlighting the need for policy adjustments.

AB - Background/Aims: This study aims to evaluate the global burden of adverse effects of medical treatment (AEMT) using data from the Global Burden of Disease Study (GBD) 2021. Methods: Data were extracted from the GBD 2021, covering 204 countries/territories from 1990 to 2021. AEMT was defined using ICD-9 and ICD-10 codes, encompassing complications from medical procedures, treatments, or healthcare exposures. Estimates were categorized into fatal and non-fatal outcomes and stratified by age, sex, year, and covariates, including the Socio-demographic Index (SDI). Mortality-incidence ratios (MIRs), defined as the ratio of mortality calculated by dividing the number of deaths by the total incident cases, were analyzed. Results: In 2021, the global age-standardized 1.53 (1.29-1.68) per 100,000 population, respectively. DALY rates were highest in the early neonatal group (4,789.47 per 100,000 population [95% UI, 3,682.00-5,963.30]), while mortality rates followed a U-shaped pattern across age groups. In 2021, MIRs were highest at both ends of the age range: the early neonatal group (0.58 [95% UI, 0.55-0.58]) and the 95+ age group (0.05 [0.04-0.06]). This pattern was consistent across all SDI quintiles, with higher MIRs observed in lower SDI quintiles. Conclusions: The significantly higher prevalence and incidence rates of AEMT among the older population in high SDI quintiles, compared to lower SDI quintiles, could be attributed to the healthcare overutilization, highlighting the need for policy adjustments.

KW - Adverse effect

KW - Disability-adjusted life years

KW - Global Burden of Disease

KW - Incidence

KW - Mortality

KW - Disability-Adjusted Life Years

KW - Prevalence

KW - Humans

KW - Middle Aged

KW - Child, Preschool

KW - Male

KW - Infant

KW - Drug-Related Side Effects and Adverse Reactions/mortality

KW - Young Adult

KW - Time Factors

KW - Aged, 80 and over

KW - Female

KW - Adult

KW - Child

KW - Infant, Newborn

KW - Global Health

KW - Risk Factors

KW - Adolescent

KW - Aged

KW - Global Burden of Disease/trends

UR - https://www.scopus.com/pages/publications/105033731434

UR - https://pure.ulster.ac.uk/en/publications/0a96c0ac-5ee9-4175-981a-d04e269dde0d

U2 - 10.3904/kjim.2025.278

DO - 10.3904/kjim.2025.278

M3 - Article

C2 - 41850226

AN - SCOPUS:105033731434

SN - 1226-3303

VL - 41

SP - 350

EP - 366

JO - Korean Journal of Internal Medicine (KJIM)

JF - Korean Journal of Internal Medicine (KJIM)

IS - 2

ER -

Global burden of adverse effects of medical treatment from 1990 to 2021: a Global Burden of Disease Study 2021

Abstract

Bibliographical note

Data Availability Statement

Funding

Keywords

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