Abstract
BACKGROUND: The magnitude and composition of global rehabilitation needs are evolving, particularly following the COVID-19 pandemic. Our study aims to systematically analyze the trends of rehabilitation needs across 195 countries and regions from 1990 to 2021 and to evaluate the impact of the COVID-19 pandemic on global rehabilitation needs. MATERIALS AND METHODS: This study included 27 health conditions for which rehabilitation is considered a key intervention, with all data from the Global Burden of Disease Study 2021. A multidimensional analytical framework was employed to analyze multiple aspects of rehabilitation needs, including segmented regression, smoothing spline models, decomposition analysis, inequality assessment, frontier analysis, and the Bayesian age-period-cohort model. RESULTS: Due to the impact of the COVID-19 pandemic, the global number of people in need of rehabilitation reached 2.56 billion in 2021, up significantly from 2.41 billion in 2019. Over the past three decades, rehabilitation needs have increased notably for neurological disorders, sensory impairments, chronic respiratory diseases, cardiovascular diseases, and neoplasms. Notably, when a country's universal health coverage effective index reaches approximately 80, the rehabilitation needs tend to stabilize or even decline. The increasing needs for rehabilitation services are primarily driven by population growth and population aging. In 2021, rehabilitation needs remained concentrated in high Sociodemographic Index (SDI) regions, but it showed a trend toward greater global equity. Frontier analysis indicated that a reduction in the burden of rehabilitation-related conditions is associated with improvements in social development. Nonetheless, certain high-SDI countries exhibited significant deviations from this trend. By 2035, the absolute number of prevalent cases with rehabilitation-related conditions is projected to reach approximately 2.64 billion. CONCLUSION: The need for rehabilitation services has increased significantly worldwide, especially following the COVID-19 pandemic. This trend places greater demands on the allocation, equity, and accessibility of global health resources.