Supplementary Material for: ‘A Global, Regional, and National Survey on Burden and Quality of Care Index (QCI) of Multiple Sclerosis; Global Burden of Disease Systematic Analysis 1990-2019’

Background: Multiple sclerosis (MS) is a common neurologic autoimmune disorder. We have used a newly introduced measure, Quality of Care Index (QCI), which is associated with the efficacy of care given to patients suffering from MS. Objective: To report and compare the quality of care given to MS patients in different regions and country. Method: Primary measures were retrieved from Global Burden of Disease (GBD) from 1990 to 2019. Secondary measures (mortality to incidence ratio, DALY to prevalence ratio, prevalence to incidence ratio, and YLL to YLD ratio) were combined using Principle Component Analysis (PCA), to form an essential component (QCI) (0-100 index with higher values representing better condition). Findings: In 2019, there were 59,345 (95% UI 51,818 to 66,943) new MS incident case globally. Global QCI of 88.4 was calculated for 2019. At national level, Qatar had the highest quality of care (100) followed by Kuwait (98.5) and Greenland (98.1). The lowest QCI was observed in Kiribati (13.5), Nauru (31.5), and Seychelles (36.3), respectively. Most countries have reached gender equity during the 30 years. Also, QCI was lowest in ages from 55 to 80 in global scale. Conclusion: MS QCI is better among those countries of higher socioeconomic status, possibly due to better healthcare access and early detection in these regions. Countries could benefit from adopting the introduced QCI to evaluate the quality of care given to MS patients in national and global level.