Trends and projections in rehabilitation demand across 3 decades in China (1990−2019)

Background: China has a large number of people with disabilities and chronic diseases who have rehabilitation needs. Objectives: To estimate the need for rehabilitation in China, we presented the prevalence and years lived with disability (YLDs) of 25 conditions that would benefit from rehabilitation over the course of their life. Methods: This study used the data from the Global Burden of Diseases Study 2019 (GBD 2019) to calculate the prevalence and YLDs. The World Health Organization Rehabilitation Need Estimator was used to calculate the results. Results: In China, 460 million 95% uncertainty interval (UI), 440−480 individuals male: 220 (220−230); female: 240 (230−250) had conditions that would benefit from rehabilitation in 2019, contributing to 63 million (47–80) YLDs male: 29 (22−37); female: 34 (26−43). There has been a 70.4% and 75.0% increase in prevalent cases (male vs. female: 69.2% vs. 84.6%) and YLDs (male vs. female: 70.6% vs. 78.9%), respectively, between 1990 and 2019. In 2019, the age-standardized rates of prevalent cases and YLDs per 1000 were 254 (95% UI, 244−264) male: 251 (243−261); female: 255 (245−267) and 35.2 (95% UI, 26.6−44.6) male: 33.2 (24.9−42.1); female: 36.9 (28.0−46.8), respectively. There has been a 2.3% and 3.0% reduction in the age-standardized rates of prevalent cases (male vs. female: −1.6% vs. −3.8%) and YLDs (male vs. female: −2.1% vs. −3.9%), respectively, between 1990 and 2019. Conclusions: This study shows that the need for rehabilitation services in China has increased significantly in the past 3 decades. Therefore, we propose that rehabilitation must be integral to “Healthy China 2030” and the whole health system—especially in primary health care—to serve more people in need.