Abstract
A basic requirement for evaluating the cost-effectiveness of health interventions is a comprehensive assessment of the amount of ill health (premature death and disability) attributable to specific diseases and injuries. A new indicator, the number of disability-adjusted life years (DALYs), was developed to assess the burden of disease and injury in 1990 for over 100 causes by age, sex and region. The DALY concept provides an integrative, comprehensive methodology to capture the entire amount of ill health which will, on average, be incurred during one's lifetime because of new cases of disease and injury in 1990. It differs in many respects from previous attempts at global and regional health situation assessment which have typically been much less comprehensive in scope, less detailed, and limited to a handful of causes. This paper summarizes the DALY estimates for 1990 by cause, age, sex and region. For the first time, those responsible for deciding priorities in the health sector have access to a disaggregated set of estimates which, in addition to facilitating cost-effectiveness analysis, can be used to monitor global and regional health progress for over a hundred conditions. The paper also shows how the estimates depend on particular values of the parameters involved in the calculation.
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Selected References
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- Beasley R. P., Hwang L. Y., Lin C. C., Chien C. S. Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22 707 men in Taiwan. Lancet. 1981 Nov 21;2(8256):1129–1133. doi: 10.1016/s0140-6736(81)90585-7. [DOI] [PubMed] [Google Scholar]
- King H., Zimmet P. Trends in the prevalence and incidence of diabetes: non-insulin-dependent diabetes mellitus. World Health Stat Q. 1988;41(3-4):190–196. [PubMed] [Google Scholar]
- Lopez A. D. Changes in tobacco consumption and lung cancer risk: evidence from national statistics. IARC Sci Publ. 1990;(103):57–76. [PubMed] [Google Scholar]
- Murray C. J., Lopez A. D. Global and regional cause-of-death patterns in 1990. Bull World Health Organ. 1994;72(3):447–480. [PMC free article] [PubMed] [Google Scholar]
- Murray C. J., Lopez A. D. Quantifying disability: data, methods and results. Bull World Health Organ. 1994;72(3):481–494. [PMC free article] [PubMed] [Google Scholar]
- Murray C. J. Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull World Health Organ. 1994;72(3):429–445. [PMC free article] [PubMed] [Google Scholar]
- Rogers R. G., Rogers A., Belanger A. Active life among the elderly in the United States: multistate life-table estimates and population projections. Milbank Q. 1989;67(3-4):370–411. [PubMed] [Google Scholar]
- Wilkins R., Adams O. B. Health expectancy in Canada, late 1970s: demographic, regional, and social dimensions. Am J Public Health. 1983 Sep;73(9):1073–1080. doi: 10.2105/ajph.73.9.1073. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van Ginneken J. K., Dissevelt A. G., van de Water H. P., van Sonsbeek J. L. Results of two methods to determine health expectancy in The Netherlands in 1981-1985. Soc Sci Med. 1991;32(10):1129–1136. doi: 10.1016/0277-9536(91)90089-u. [DOI] [PubMed] [Google Scholar]
