title: Disability Adjusted Life Years (DALYs) and rehabilitation.
abstract: OBJECTIVE
  The Disability Adjusted Life Year (DALY) is a unit that was developed for use in cost-effectiveness analysis and epidemiology studies. It is a combined measure of both death and disability, and has been extensively utilized in several countries and across various conditions. The purpose of this paper is to examine the implications for rehabilitation of the widespread use of this measure.
  
  
  METHODS
  The premises upon which the disability weight were developed are examined in the light of existing literature.
  
  
  CONCLUSIONS
  It is concluded that, whereas the incorporation of the impact of disability on disease burden is to be lauded, the DALY is insensitive to changes in disability status. Consequently, resource allocation to rehabilitation activities based on cost-effectiveness analysis using DALYs may be diminished. There is also a dearth of epidemiological information relating to disability and it is incumbent on rehabilitation professionals to address this lack. The DALY protocol is under revision and those concerned with rehabilitation issues should contribute to the debates surrounding cost-effectiveness analysis and the units that are used to determine the effectiveness component.
authors.affiliation: Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Cape Town, South Africa. jjelsma@uctgshl.uct.ac.za
authors.forename: Jennifer
authors.initials: J
authors.lastname: Jelsma
authors.forename: Willy
authors.initials: W
authors.lastname: De Weerdt
authors.forename: Paul
authors.initials: P
authors.lastname: De Cock
mesh_terms: D017281:Cost of Illness; D003362:Cost-Benefit Analysis / Q000379:methods; D006233:Persons with Disabilities / Q000145:classification* / Q000706:statistics & numerical data; D015276:Health Care Rationing; D006801:Humans; D019057:Quality-Adjusted Life Years; D012046:Rehabilitation / Q000191:economics; D026712:Value of Life / Q000191:economics*