title: A healthy bottom line: healthy life expectancy as an outcome measure for health improvement efforts.
abstract: BACKGROUND
  Good health is the most important outcome of health care, and healthy life expectancy (HLE), an intuitive and meaningful summary measure combining the length and quality of life, has become a standard in the world for measuring population health.
  
  
  METHODS
  This article critically reviews the literature and practices around the world for measuring and improving HLE and synthesizes that information as a basis for recommendations for the adoption and adaptation of HLE as an outcome measure in the United States.
  
  
  RESULTS
  This article makes the case for adoption of HLE as an outcome measure at the national, state, community, and health care system levels in the United States to compare the effectiveness of alternative practices, evaluate disparities, and guide resource allocation.
  
  
  CONCLUSIONS
  HLE is a clear, consistent, and important population health outcome measure that can enable informed judgments about value for investments in health care.
authors.affiliation: Kaiser Permanente, One Kaiser Plaza, 18th Floor, Oakland, CA 94612, USA. matt.stiefel@kp.org
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Stiefel
authors.forename: Rocco J
authors.initials: RJ
authors.lastname: Perla
authors.forename: Bonnie L
authors.initials: BL
authors.lastname: Zell
mesh_terms: D001294:Attitude to Health; D019992:Databases as Topic; D016208:Databases, Factual / Q000706:statistics & numerical data*; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D006304:Health Status; D054624:Health Status Disparities; D006305:Health Status Indicators; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008498:Medical Record Linkage; D009026:Mortality / Q000639:trends; D012959:Socioeconomic Factors; D014481:United States