Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Nat Med. 2024 Nov;30(11):3335-3344. doi: 10.1038/s41591-024-03248-4. Epub 2024 Sep 27.
With population aging, national health systems face difficult trade-offs in allocating resources. The World Bank launched the Healthy Longevity Initiative to generate evidence for investing in policies that can improve healthy longevity and human capital. As part of this initiative, we quantified the economic value of reducing avoidable mortality from major noncommunicable diseases and injuries. We estimated avoidable mortality-the difference between lowest-achieved mortality frontiers and projected mortality trajectories-for each cause of death, for 2000, 2019 and 2050, and for geographic regions, with high-income countries, India and China considered separately; we applied economic values to these estimates. The economic value of reducing cardiovascular disease avoidable mortality would be large for both sexes in all regions, reaching 2-8% of annual income in 2019. For cancers, it would be 5-6% of annual income in high-income countries and China, and for injuries, it would be around 5% in sub-Saharan Africa and Latin America and the Caribbean. Despite the large uncertainty surrounding our estimates, we offer economic values for reducing avoidable mortality by cause and metrics comparable to annual incomes, which enable multisectoral priority setting and are relevant for high-level policy discussions around budget and resource allocations.
随着人口老龄化,国家卫生系统在分配资源方面面临着艰难的权衡取舍。世界银行发起了健康长寿倡议,以生成投资于能够改善健康长寿和人力资本的政策的证据。作为该倡议的一部分,我们量化了减少主要非传染性疾病和伤害可避免死亡率的经济价值。我们估计了每个死因的可避免死亡率——最低实现死亡率前沿与预计死亡率轨迹之间的差异,分别针对 2000 年、2019 年和 2050 年以及高收入国家、印度和中国等地理区域;我们对这些估计应用了经济价值。在所有地区,减少心血管疾病可避免死亡率对男性和女性都具有巨大的经济价值,在 2019 年达到年收入的 2-8%。对于癌症,在高收入国家和中国,其经济价值将占年收入的 5-6%,而对于伤害,在撒哈拉以南非洲和拉丁美洲及加勒比地区,其经济价值将约占年收入的 5%。尽管我们的估计存在很大的不确定性,但我们提供了按病因和指标衡量的减少可避免死亡率的经济价值,与年收入相当,这使多部门能够进行优先排序,并与围绕预算和资源分配的高级别政策讨论相关。