A QALY-based societal health statistic for Canada, 1985.

This paper assesses the appropriateness of QALYs (quality adjusted life years) as a foundation for an index of societal health, and the feasibility of using such an index to guide health care policy. Results of this paper suggest that the standard aggregate QALY index imposes an ethical position on policy makers which may promote inequality in well-being associated with health. It is possible to rectify this problem in theory, but current data are insufficient to estimate such corrected indices. A QALY-based index, constructed using the best available data, indicates morbidity has a significant effect on Canadian health status (e.g. life expectancy figures alone overstate community health by about 10%), that the impact of morbidity is unequal across regions and gender, and that role (the ability to fulfil social functions) and mobility dysfunction are important determinants of ill-health in this population.