HALYS and QALYS and DALYS, Oh My: similarities and differences in summary measures of population Health.
Health-adjusted life years (HALYs) are population health measures permitting morbidity and mortality to be simultaneously described within a single number. They are useful for overall estimates of burden of disease, comparisons of the relative impact of specific illnesses and conditions on communities, and in economic analyses. Quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs) are types of HALYs whose original purposes were at variance. Their growing importance and the varied uptake of the methodology by different U.S. and international entities makes it useful to understand their differences as well as their similarities. A brief history of both measures is presented and methods for calculating them are reviewed. Methodological and ethical issues that have been raised in association with HALYs more generally are presented. Finally, we raise concerns about the practice of using different types of HALYs within different decision-making contexts and urge action that builds and clarifies this useful measurement field.
Gold
Marthe R
MR
Department of Community Health and Social Medicine, City University of New York Medical School, 138th Street and Convent Avenue, New York, New York 10031, USA. Goldmr@med.cuny.edu
Stevenson
David
D
Fryback
Dennis G
DG
D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D006233:Persons with Disabilities; D004989:Ethics; D006305:Health Status Indicators; D006801:Humans; D011159:Population Surveillance; D011634:Public Health; D019057:Quality-Adjusted Life Years; D014481:United States / Q000453:epidemiology