Anand S, Hanson K
St. Catherine's College, Oxford, UK.
J Health Econ. 1997 Dec;16(6):685-702. doi: 10.1016/s0167-6296(97)00005-2.
The disability-adjusted life year (DALY) has emerged in the international health policy lexicon as a new measure of the 'burden of disease'. We argue that the conceptual and technical basis for DALYs is flawed, and its assumptions and value judgements are open to serious question. In particular, the implications of age-weighting and discounting are found to be unacceptable. Moreover, the proponents of DALYs do not distinguish between the exercises of measuring the burden of disease and of allocating resources. But the appropriate information sets for the two exercises are quite different. Allocating resources by aggregate DALY-minimization is shown to be inequitable.
伤残调整生命年（DALY）已作为一种衡量“疾病负担”的新指标出现在国际卫生政策词汇表中。我们认为，DALY的概念和技术基础存在缺陷，其假设和价值判断也存在严重问题。特别是，年龄加权和贴现的影响被认为是不可接受的。此外，DALY的支持者没有区分衡量疾病负担和分配资源这两项工作。但这两项工作所需的信息集截然不同。通过使DALY总量最小化来分配资源被证明是不公平的。
