University of Liverpool/NHS Wirral, Merseyside, UK.
Value Health. 2013 Jun;16(4):599-603. doi: 10.1016/j.jval.2013.01.004. Epub 2013 Mar 26.
There has been a policy debate in the United Kingdom about moving beyond traditional measures of life expectancy and economic output to developing more meaningful ways of measuring national well-being.
To test whether quality adjusted life expectancy (QALE) was a useful indicator of health inequalities.
EuroQol five-dimensional questionnaire data from a well-being survey was combined with actuarial life expectancy (LE) data to estimate healthy LE (HLE), that is, years of life lived in good health, and QALE, that is, quality-adjusted life-years (QALYs) lived for Wirral, a borough in the north west of England.
The gap between Wirral and the most deprived areas was 4.45 years for LE, 5.34 for QALE, and 7.55 for HLE. The gap in QALE was 20% greater than the gap in LE, while the gap in HLE was 70% greater.
The fact that the QALE gap value lies between the HLE value and the LE value suggests that QALE is a more sensitive indicator than HLE, as in this study QALE is derived from 243 possible EuroQol five-dimensional questionnaire profiles whereas HLE is based only on whether or not an individual rates his or her health as good, a binary variable. This study discusses how QALE could be a useful indicator for measuring health inequalities in future, especially as cost utility and QALYs are seen as the gold standard used by the National Institute for Health and Clinical Excellence in the United Kingdom to measure outcomes for health interventions in England, and discusses how a monetary valuation of QALYs could be used to put a societal cost on health inequalities.
英国一直在就超越传统的预期寿命和经济产出衡量标准展开政策辩论，以寻求更有意义的衡量国家福祉的方法。
测试质量调整生命期望（QALE）是否是衡量健康不平等的有用指标。
将幸福感调查中的 EuroQol 五维问卷数据与精算预期寿命（LE）数据相结合，以估计健康预期寿命（HLE），即健康生活的预期寿命，以及 QALE，即调整质量的预期寿命（QALYs）。Wirral 是英格兰西北部的一个自治市。
LE 方面，Wirral 与最贫困地区之间的差距为 4.45 年，QALE 为 5.34 年，HLE 为 7.55 年。QALE 的差距比 LE 的差距大 20%，而 HLE 的差距则大 70%。
QALE 的差距值介于 HLE 值和 LE 值之间，这表明 QALE 比 HLE 更敏感，因为在这项研究中，QALE 是从 243 个可能的 EuroQol 五维问卷概况中得出的，而 HLE 仅基于个人是否将其健康状况评为良好，这是一个二元变量。本研究讨论了 QALE 如何成为未来衡量健康不平等的有用指标，尤其是因为成本效用和 QALYs 被视为英国国民健康与临床卓越研究所用于衡量英格兰健康干预措施结果的黄金标准，并讨论了如何使用 QALYs 的货币估值来衡量健康不平等的社会成本。
