Calculating and presenting disability adjusted life years (DALYs) in cost-effectiveness analysis
Calculating and presenting disability adjusted life years (DALYs) in cost-effectiveness analysis
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DOI：
10.1093/heapol/16.3.326
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发表时间：
2001-09-01
影响因子：
3.2
通讯作者：
Hanson, K
中科院分区：
文献类型：
--
作者：
Rushby, JF;Hanson, K
残疾调整生命年（DALYs）是由于过早死亡而损失的未来生命年的现值，以及根据疾病或伤害造成的任何精神或身体残疾的平均严重程度（频率和强度）调整的未来生命年的现值的总和。它们已被用作微观经济评价的结果指标以及利用成本效益排行榜确定部门优先次序的工作。然而，目前的许多分析不具有可比性或可转移性，因为所使用的假设不同或不清楚，并且因为结果的呈现方式不允许研究人员或政策制定者重新计算和重新解释研究结果，以便在另一种情况下使用。然而，有时也会出现误判。这可能是因为评估人员不同意DALYs背后的假设，或者因为计算方法没有明确规定。本文通过一个实例说明了如何计算DALYs以进行成本效益分析。它还显示了改变年龄加权和贴现率对成本效益估计的影响，并建议在成本效益分析中使用伤残调整生命年的一套最低报告标准。最后，向读者简要介绍了支持和反对使用DALYs的选定文献。
Disability adjusted life years (DALYs) are the sum of the present value of future years of lifetime lost through premature mortality, and the present value of years of future lifetime adjusted for the average severity (frequency and intensity) of any mental or physical disability caused by a disease or injury. They have been used as an outcome indicator in micro economic evaluations as well as sectoral prioritization exercises using league tables of cost-effectiveness. However, many of the current analyses are not comparable or transferable because either the assumptions used differ or are unclear, and because results are not presented in a way that allows researchers or policy-makers to re-calculate and re-interpret findings for use in an alternative context. However, at times there have also been miscalculations. This may happen either because evaluators disagree with the assumptions behind DALYs or because the methods of calculation have not been set out clearly. This paper shows how to calculate DALYs for cost-effectiveness analysis using a worked example. It also shows the impact of changing the age weighting and discount rates on estimates of cost-effectiveness, and suggests a set of minimum reporting criteria for using DALYs in cost-effectiveness analysis. Finally, readers are introduced briefly to a selected literature arguing for and against the use of DALYs.