Diehr P, Patrick D L, Bild D E, Burke G L, Williamson J D
Department of Biostatistics, University of Washington, Seattle 98195, USA.
J Clin Epidemiol. 1998 Apr;51(4):343-53. doi: 10.1016/s0895-4356(97)00298-9.
Cost-effectiveness studies often need to compare the cost of a program to the lifetime benefits of the program, but estimates of lifetime benefits are not routinely available, especially for older adults. We used data from two large longitudinal studies of older adults (ages 65-100) to estimate transition probabilities from one health state to another, and used those probabilities to estimate the mean additional years of healthy life that an older adult of specified age, sex, and health status would experience. We found, for example, that 65-year-old women in excellent health can expect 16.8 years of healthy life in the future, compared to only 8.5 years for women in poor health. We also provide estimates of discounted years of healthy life and future life expectancy. These estimates may be used to extend the effective length of the study period in cost-effectiveness studies, to examine the impact of chronic diseases or risk factors on years of healthy life, or to investigate the relationship of years of life to years of healthy life. Several applications are described.
成本效益研究通常需要将一个项目的成本与其终身效益进行比较，但终身效益的估计并非常规可得，尤其是对于老年人而言。我们使用了两项针对老年人（65 - 100岁）的大型纵向研究的数据来估计从一种健康状态转变为另一种健康状态的概率，并利用这些概率来估计特定年龄、性别和健康状况的老年人预期额外拥有的健康生活年数。例如，我们发现健康状况极佳的65岁女性未来有望拥有16.8年的健康生活，而健康状况较差的女性则只有8.5年。我们还提供了贴现后的健康生活年数和未来预期寿命的估计值。这些估计值可用于在成本效益研究中延长研究期的有效时长，以检验慢性病或风险因素对健康生活年数的影响，或研究生命年数与健康生活年数之间的关系。文中描述了几种应用情况。
