Evaluation of the impact of various diseases on mortality.

The scarcity of resources within the health sector creates serious allocation problems. If it were legitimate to allocate the available means to the various diseases according to their impact on the length of human life, how should this impact be evaluated? That is the purpose of this study, which compares and evaluates methods for measuring the importance of various diseases from the point of view of their lethal effects and significance for life expectancy.THREE METHODS OF EVALUATION HAVE BEEN USED: the percentage of all deaths due to the disease (method A); the gain in life expectancy that would occur if the disease were eradicated as a cause of death (method B); and the change in the ratio between productive and nonproductive groups that would result from eliminating the disease as a cause of death (method C). The analyses are based on the total number of deaths in Denmark in 1969 and 1971. According to (A), one-third of all deaths was caused by heart diseases, one-fourth by cancer, and one-tenth by stroke. The results of method (B) were in agreement with those of method (A); the greatest gain in life expectancy was obtained by eliminating cardiac diseases; cancer ranked second, and accidents third for men and fourth for women. Method (C) yielded contrasting results. The result of eliminating most diseases would be a decrease in the proportion of persons of productive age. This was most distinct for cardiac diseases. The most important exception to this rule was accidents: if these were eliminated, the distribution of the population in the productive and nonproductive age groups would remain stable.