Newly estimated disability weights for 196 health states in Hubei Province, China.

BACKGROUND

The disability weight (DW) reflects the severity of non-fatal outcomes and is an important parameter in calculating the burden of disease. However, the universality of the global, national, or subnational DWs remains controversial. This study aims to measure DWs specific to Hubei Province of China using non-parametric regression to anchor the DWs.

METHODS

Paired comparison (PC) data collected from a web-based survey in Hubei Province targeting the general population were used to estimate the DWs of 196 health states. Specifically, PC data from 33,925 respondents were analyzed by probit regression analysis, and the results were then anchored to 0-1 scale using non-parametric regression based on the DWs from Global Burden of Disease (GBD) 2013. The absolute DW values and rankings were compared to those in the Chinese disability weight measurement study, GBD 2013, and Japan.

RESULTS

The DWs for 196 health states ranged from 0.003 for mild distance vision impairment to 0.663 for severe heroin and opioid dependence in Hubei Province, China. Quite a lot mental disorders, such as moderate/severe episode of major depressive disorder, were considered more severe than the terminal phase with/without medication among Hubei residents. DW rankings of the health states are relatively stable in Hubei Province irrespective of the anchoring method used. A very small proportion (4 of 196, 2%) of DW rankings changed by 10 or more positions in China when compared with our results, but approximately 61% in GBD 2013 and 59% in Japan. Among the top 25 health states in this study, 9 of 11 health states categorized as mental, behavioral, and substance use disorders resulted in a lower ranking in GBD 2013, and all 6 states in Japan also showed a lower ranking, whereas China shared a similar ranking.

CONCLUSIONS

The burden of mental disorders among Hubei residents, especially moderate or severe major depressive disorder, deserves further attention. When using different anchoring methods, DW rankings were maintained relatively stable rather than the absolute values in Hubei. Substantial differences of DW rankings between our results and that in China, GBD 2013, and Japan draw attention to the need for deriving local disability for disease burden calculation.