Abstract
QALYs, DALYs and life years gained are all common outcome measures in economic evaluations of health interventions. While the latter is a pure measure of mortality, QALYs and DALYs are measures that combine mortality with morbidity in single numerical units, an exercise involving trade-offs between quantity for quality of health. Some authors have argued that mortality and morbidity are totally different dimensions, and combining them into a single numerical unit is nonsensious. Others have argued that the exercise is necessary in order to convert principles for resource allocation to criteria that can be used in a consistent manner. This paper has a two-fold objective, namely to discuss the differences between these health measures, and to explore what difference they are likely to make for health care priority setting in sub-Saharan Africa.
Highlights
The total population of Africa is some 655 million people, who experience an annual loss of about 358 million disability adjusted life years (DALYs)
The objectives of this paper are to present the major differences between three commonly applied health measures; life years gained (LYs gained), quality adjusted life years (QALYs) and disability adjusted life years (DALYs). It will be explored what difference these alternative measures may have for health care priority setting in sub-Saharan Africa
Bleichrodt and colleagues estimated equity weights in two Dutch populations. When they incorporated these weights in QALY calculations, they found that this changed the ranking of 12 health interventions [27]. These findings suggest that the issue of equity weighting need further research, it is likely that such an enterprise will be quite data hungry [25]
Summary
QALYs, DALYs and life years gained are all common outcome measures in economic evaluations of health interventions. While the latter is a pure measure of mortality, QALYs and DALYs are measures that combine mortality with morbidity in single numerical units, an exercise involving trade-offs between quantity for quality of health. Some authors have argued that mortality and morbidity are totally different dimensions, and combining them into a single numerical unit is nonsensious. Others have argued that the exercise is necessary in order to convert principles for resource allocation to criteria that can be used in a consistent manner. This paper has a two-fold objective, namely to discuss the differences between these health measures, and to explore what difference they are likely to make for health care priority setting in sub-Saharan Africa
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