Adjusting life for quality or disability: stylistic difference or substantial dispute?

Mara Airoldi, Alec Morton

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

This paper focuses on the contrast between describing the benefit of a healthcare intervention as gain in health (QALY-type ideas) or a disability reduction (DALY-type ideas). The background is an apparent convergence in practice of the work conducted under both traditions. In the light of these methodological developments, we contrast a health planner who wants to maximise health and one who wants to minimise disability. To isolate the effect of framing the problem from a health or a disability perspective, we do not use age-weighting in calculating DALY and employ a common discounting methodology and the same set of quality of life weights. We find that interventions will be ranked in a systematically different way. The difference, however, is not determined by the use of a health or a disability perspective but by the use of life expectancy tables to determine the years of life lost. We show that this feature of the DALY method is problematic and we suggest its dismissal in favour of a fixed reference age rendering the use of a health or a disability perspective merely stylistic.
Original languageEnglish
Pages (from-to)1237–1247
Number of pages11
JournalHealth Economics
Volume18
Issue number11
Early online date18 Dec 2008
DOIs
Publication statusPublished - Nov 2009

Keywords

  • QALY
  • DALY
  • economic evaluation
  • healthcare intervention

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