Abstract
BackgroundBurden of disease estimates are an important resource in public health. Currently, robust estimates are not available for the burn population. Our objectives are to adapt a refined methodology (INTEGRIS method) to burns and to apply this new INTEGRIS-burns method to estimate, and compare, the burden of disease of burn injuries in Australia, New Zealand and the Netherlands.MethodsExisting European and Western-Australian health-related quality of life (HRQL) datasets were combined to derive disability weights for three homogenous burn injury groups based on percentage total body surface area (%TBSA) burned. Subsequently, incidence data from Australia, New Zealand, and the Netherlands from 2010 to 2017 were used to compute annual non-fatal burden of disease estimates for each of these three countries. Non-fatal burden of disease was measured by years lived with disability (YLD).ResultsThe combined dataset included 7159 HRQL (EQ-5D-3 L) outcomes from 3401 patients. Disability weights ranged from 0.046 (subgroup < 5% TBSA burned > 24 months post-burn) to 0.497 (subgroup > 20% TBSA burned 0–1 months post-burn). In 2017 the non-fatal burden of disease of burns for the three countries (YLDs/100,000 inhabitants) was 281 for Australia, 279 for New Zealand and 133 for the Netherlands.ConclusionsThis project established a method for more precise estimates of the YLDs of burns, as it is the only method adapted to the nature of burn injuries and their recovery. Compared to previous used methods, the INTEGRIS-burns method includes improved disability weights based on severity categorization of burn patients; a better substantiated proportion of patients with lifelong disability based; and, the application of burn specific recovery timeframes. Information derived from the adapted method can be used as input for health decision making at both the national and international level. Future studies should investigate whether the application is valid in low- and middle- income countries.
Highlights
Burden of disease estimates are an important resource in public health
Spronk et al BMC Public Health (2020) 20:121 (Continued from previous page). This project established a method for more precise estimates of the years lived with disability (YLD) of burns, as it is the only method adapted to the nature of burn injuries and their recovery
Compared to previous used methods, the INTEGRIS-burns method includes improved disability weights based on severity categorization of burn patients; a better substantiated proportion of patients with lifelong disability based; and, the application of burn specific recovery timeframes
Summary
Burden of disease estimates are an important resource in public health. Currently, robust estimates are not available for the burn population. Burden of disease comprises all health consequences of a disease or injury in one metric: the disability adjusted life year (DALY), which allows comparison across diseases and injuries, populations, and over time [1,2,3]. This metric combines information regarding loss of health due to premature mortality with information on non-fatal disabling effect of diseases and/or injuries in one single figure [4,5,6]. Combining information regarding the duration of the disability with the disease or injury specific disability weights is necessary to derive adequate YLDs and DALYs [10]
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