衡量疾病负担：健康生命年
Measuring the burden of disease: healthy life-years.
作者信息
Hyder A A, Rotllant G, Morrow R H
机构信息
Department of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
出版信息
Am J Public Health. 1998 Feb;88(2):196-202. doi: 10.2105/ajph.88.2.196.
OBJECTIVES
This paper presents the background and rationale for a composite indicator, healthy life-year (HeaLY), that incorporates mortality and morbidity into a single number. HeaLY is compared with the disability-adjusted life-year (DALY) indicator, to demonstrate the relative simplicity and ease of use of the former.
METHODS
Data collected by the Ghana Health Assessment team from census records, death certificates, medical records, and special studies were used to create a spreadsheet. HeaLYs lost as a result of premature mortality and disability from 56 conditions were estimated.
RESULTS
Two thirds of HeaLYs lost in Ghana were from maternal and communicable diseases and were largely preventable. The age weighting in DALYs leads to a higher value placed on deaths at younger ages than in HeaLYs. This spreadsheet can be used as a template for assessing changes in health status attributable to interventions.
CONCLUSIONS
HeaLY can aid in setting health priorities and identifying disadvantaged groups. The disaggregated approach of the HeaLY spreadsheet tool is simpler for decision makers and useful for country application.
目标
本文介绍了综合指标“健康生命年”（HeaLY）的背景和基本原理，该指标将死亡率和发病率纳入一个单一数值。将HeaLY与伤残调整生命年（DALY）指标进行比较，以证明前者相对简单且易于使用。
方法
加纳健康评估团队从人口普查记录、死亡证明、医疗记录和专项研究中收集的数据用于创建一个电子表格。估算了因56种疾病导致的过早死亡和残疾所损失的健康生命年。
结果
加纳损失的健康生命年中有三分之二来自孕产妇和传染病，且大多是可预防的。DALYs中的年龄加权导致对较年轻年龄死亡的估值高于健康生命年中的估值。此电子表格可作为评估干预措施所致健康状况变化的模板。
结论
HeaLY有助于确定卫生工作重点和识别弱势群体。HeaLY电子表格工具的分类方法对决策者而言更简单，且对国家应用很有用。
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