Rodda Sheridan, Morton Jedidiah, Lloyd Melanie, Norman Richard, Ademi Zanfina
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia; Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
Value Health. 2025 Jun;28(6):923-929. doi: 10.1016/j.jval.2025.02.016. Epub 2025 Apr 9.
Detailed and current information on the social distribution of health across gradients of socioeconomic disadvantage and geographic remoteness in Australia is limited. Quality-adjusted life expectancy (QALE) is a useful summary measure of population health, combining mortality and health-related quality of life. This cross-sectional study estimates QALE by year age for the Australian population across sex, socioeconomic disadvantage, and remoteness groups, providing a baseline for equity-focused health technology assessments.
Short Form-6 Dimension data were obtained from the Household, Income, and Labor Dynamics survey for 2022 and 2023, from which mean utility scores by age were estimated using linear regression. Mortality data for 2022 from the Australian Bureau of Statistics were used to construct life tables to generate life expectancy (LE), into which health-related quality of life was incorporated to derive age and sex-specific QALE across quintiles of socioeconomic disadvantage and remoteness areas.
At birth, individuals in the most disadvantaged quintile had an undiscounted LE of 78.7 years and QALE of 43.9 years compared with those in the least-disadvantaged quintile with undiscounted LE of 86.3 years and QALE of 55.6 years. A small gradient existed across remoteness areas, with individuals residing in major cities experiencing 2.6 years greater LE and QALE of 3.8 years (both undiscounted) above those in outer regional or remote areas.
Our study demonstrates major inequalities associated with socioeconomic disadvantage and remoteness for LE and QALE. The social distribution of health status provided in this study can be used in future equity-informed economic evaluations.
关于澳大利亚社会经济劣势梯度和地理偏远地区健康状况的详细且最新的信息有限。质量调整生命预期（QALE）是衡量人群健康的一个有用的综合指标，它综合了死亡率和与健康相关的生活质量。这项横断面研究按年龄组估算了澳大利亚不同性别、社会经济劣势和偏远程度群体的QALE，为以公平为重点的健康技术评估提供了一个基线。
从2022年和2023年的家庭、收入和劳动力动态调查中获取简式-6维度数据，通过线性回归估算各年龄组的平均效用得分。利用澳大利亚统计局2022年的死亡率数据构建生命表以得出预期寿命（LE），并将与健康相关的生活质量纳入其中，以得出不同社会经济劣势五分位数和偏远地区的特定年龄和性别的QALE。
出生时，最弱势五分位数组的个体未贴现预期寿命为78.7岁，QALE为43.9岁，而最不弱势五分位数组的个体未贴现预期寿命为86.3岁，QALE为55.6岁。偏远地区存在一个小梯度，居住在大城市的个体比外区域或偏远地区的个体预期寿命长2.6岁，QALE高3.8岁（均为未贴现）。
我们的研究表明，在预期寿命和QALE方面，存在与社会经济劣势和偏远程度相关的重大不平等。本研究提供的健康状况社会分布可用于未来基于公平的经济评估。
