Calculation of prefectural disability-adjusted life expectancy (DALE) using long-term care prevalence and its socioeconomic correlates in Japan
Calculation of prefectural disability-adjusted life expectancy (DALE) using long-term care prevalence and its socioeconomic correlates in Japan
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DOI：
10.1016/j.healthpol.2005.06.017
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发表时间：
2006-05-01
期刊：
影响因子：
3.3
通讯作者：
Takano, T
中科院分区：
文献类型：
--
作者：
Kurimori, S;Fukuda, Y;Takano, T
目的：本研究的目的是：(1)利用长期护理的普及率来确定残疾权重，即用于计算残疾调整预期寿命(DALE)的“效用”；(2)计算县DALE；以及(3)阐明DALE与日本地区社会经济状况的关系。方法：通过对236名专业人员的调查，确定长期护理保险护理水平(支持度和I-V级)的残疾效用。使用确定的效用、长期护理普及率和生命表计算了47个县65岁时的死亡率(DALE65)和年龄调整后的加权残疾流行率(AIDP)。结果：确定的效用分别为：支持度0.78；水平I，0.68；水平II，0.64；水平III，0.44；水平IV，0.34；水平V，0.21。该县男性的DALE65岁为17.11岁至15.29岁，女性为20.21岁至18.42岁。无论男女，DALE65与死亡率都有很强的相关性。男性DALE65与无社会经济指标相关，女性DALE65与部分指标相关。WDP与反映老年人社会经济劣势的指标，如失业率和老年独户百分比呈正相关。结论：DALE和WDP的社会经济相关性表明，有利的社会经济政策，加上主要原因死亡率的降低，将有助于显著延长老年人的独立期。这里提出的方法鼓励在卫生政策中实际使用健康预期，特别是在地方和区域一级。(C)2005爱思唯尔爱尔兰有限公司。保留所有权利。
Objectives: The objectives of this study were: (1) to determine the disability weight, "utility", for calculation of disability-adjusted life expectancy (DALE) using the prevalence of long-term care; (2) to calculate prefectural DALE; and (3) to clarify the relation between DALE and area socioeconomic conditions in Japan.Methods: Disability utility by care level (support and levels I-V) of long-term care insurance was determined by a survey of 236 professionals with four standard utility measures: EuroQol-5D, time trade-off, standard gamble, and visual analogue scale. DALE at age 65 (DALE65) and age-adjusted weighted disability prevalence (AIDP) of 47 prefectures were calculated using the determined utilities, prevalence of long-term care, and life tables. The relationships of DALE and WDP to mortality from major causes and socioeconomic indicators were examined by correlation analysis.Results: The determined utilities were: support, 0.78; level I, 0.68; level II, 0.64; level III, 0.44; level IV, 0.34; and level V, 0.21. The prefectural DALE65 ranged from 17.11 to 15.29 years for men and from 20.21 to 18.42 years for women. Strong correlations were found between DALE65 and mortality for both sexes. Male DALE65 was correlated with no socioeconomic indicators, while female DALE65 was correlated with some indicators. WDP was positively associated with indicators representing socioeconomic disadvantage, such as unemployment rate and percentage of elderly single households.Conclusions: The socioeconomic correlates of DALE and WDP suggested that favorable socioeconomic policies, in addition to a decrease in mortality from major causes, will contribute to significant extension of the independence period in the elderly. The method proposed here encourages the practical use of health expectancy in health policy, especially at local and regional levels. (c) 2005 Elsevier Ireland Ltd. All rights reserved.