ICIDH in the calculation of health expectancy.

In this paper the use of the ICIDH in the field of calculating health expectancies is examined. The health indicator 'health expectancy' is an adaptation of the indicator 'life expectancy'; health expectancies reflect the expected number of years lived in good health in a population. To date, health expectancies have been calculated for many countries. However, many different concepts of health have been used. The theoretical framework of the ICIDH has been proposed to harmonize the calculations of health expectancy. In this paper we explore this idea. To examine the possibility to use the ICIDH framework, we calculated health expectancies for The Netherlands, trying to follow the ICIDH. Subsequently, we reviewed the health expectancies calculated for other countries, and tried to fit those into the ICIDH framework. Much of the work done could be fitted into this framework. An important exception, however, are those health expectancies that try to capture a concept of health that is more compassing than impairments, disabilities and handicaps. Although it is possible to classify different health expectancies according to the ICIDH, this does not make health expectancies within a certain class comparable. Both the calculations carried out for The Netherlands, and the comparison of instruments used internationally, show that the instruments used to measure, for example, disabilities, yield results which are not comparable. Continuing efforts to standardize measurement instruments are needed.