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HLY and other indicators of healthy life expectancy

HLY and other indicators of healthy life expectancy. Meeting of the European Directors of Social Statistics Luxembourg, 23 September 2010 Federico Paoli. Structure of the presentation. 1. Overview of health expectancy indicators 2. Comparison between indicators

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HLY and other indicators of healthy life expectancy

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  1. HLY and other indicators of healthy life expectancy Meeting of the European Directors of Social Statistics Luxembourg, 23 September 2010 Federico Paoli

  2. Structure of the presentation 1. Overview of health expectancy indicators 2. Comparison between indicators 3. Some insights on Healthy Life Years

  3. "Increased longevity without quality of life is an empty prize. Health expectancy is more important than life expectancy.” Dr Hiroshi Nakajima, Director-General, W.H.O 1997

  4. Life expectancy Health expectancy Number of years a person can be expected to live in good health

  5. Overview of health expectancy indicators • QALY • DALY • HALE • HLY

  6. Overview of health expectancy indicators: QALY (Quality-adjusted life year) Health outcome measurement unit that combines duration and quality of life QALYs lived in one year = 1 x Q (Q ≤ 1) QALE at age a = ∑t=aa+L Qt

  7. Overview of health expectancy indicators: DALY (Disability-adjusted life year) Overall disease burden measurement, combining time lived with disability and time lost due to premature mortality Years of life lost due to premature mortality (YLL) + Years lived with disability(YLD) = DALY . YLL = N x L YLD = I x DW x L

  8. Overview of health expectancy indicators: HALE(Health-adjusted life expectancy) • Average number of years that a person can expect to live in ‘full health’ by taking into accounts years lived in less than full health due to disease and/or injury (WHO) • Three inputs: • Life expectancy at each age (standard way) • Estimates of the prevalence of various states of health at each age • Method for weighting time in less than full health

  9. Overview of health expectancy indicators: HLY(Healthy life years) Average number of years people can expect to live without health-related activity limitations. = disability-free life expectancy (DFLE) Two inputs: 1. Life expectancy at each age (standard way) 2. Estimates of the prevalence of activity limitations at each age

  10. Comparison between indicators • QALY vs DALY • DALY/HALE vs HLY

  11. Comparison between indicators:QALY vs DALY • DALY incorporates an age-weighting function • Life weights in QALY measure levels of quality of life, in DALY loss of functioning caused by diseases • DALY’s standard weights based on experts’ calculations vs QALY’s based on preference-related measures, elicited from population samples/groups of patients

  12. Comparison between indicators:DALY/HALE vs HLY • requiring experts’ estimation vs based on observed data HALE calculated through Global Burden of Diseases, Multi-Country Survey Study and World Health Survey HLY based on figures collected through the Minimum European Health Module (EU-SILC, EHIS)

  13. Comparison between indicators:DALY/HALE vs HLY • multistate vs Sullivan method

  14. Comparison between indicators:DALY/HALE vs HLY • non addictive vs addictive

  15. Some insights on Healthy Life Years • 3 possible ways of defining health expectancy, according to collected data: • disability-free life expectancy • life expectancy in good perceived health • life expectancy without chronic diseases

  16. Total life expectancy vs HLY - EU27, 2007 At birth At age 65

  17. Some insights on Healthy Life Years More information on: EUROSTAT SANCO webpage ECHI tool

  18. Links: EUROSTAT: http://ec.europa.eu/eurostat EUROSTAT / statistics database: http://epp.eurostat.ec.europa.eu/portal/page/portal/statistics/search_database SANCO public health: http://ec.europa.eu/health/index_en.htm HLY: http://ec.europa.eu/health/indicators/healthy_life_years/index_en.htm ECHI tool at SANCO webpage: http://ec.europa.eu/health/indicators/indicators/index_en.htm Minimum European Health Module on EHEMU: http://www.ehemu.eu/pdf/healthmodule/TR_2010_4.6_Health_module.pdf HALE on WHO webpage: http://www.who.int/whosis/indicators/2007HALE0/en/ DALY on WHO webpage: http://www.who.int/healthinfo/global_burden_disease/metrics_daly/en/index.html

  19. Thank you. federico.paoli@ec.europa.eu

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