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A national burden of disease calculation: Dutch disability-adjusted life-years. Dutch Burden of Disease Group

Johan M. Melse · Marie‐Louise Essink‐Bot · Pieter G. N. Kramers · Nancy Hoeymans

216 citations0/0 files storedAmerican Journal of Public Health

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Health Systems, Economic Evaluations, Quality of Life Insurance, Mortality, Demography, Risk Management Global Health and Epidemiology

Abstract

OBJECTIVES: This study estimated the burden of disease due to 48 major causes in the Netherlands in 1994 in disability-adjusted life-years (DALYs), using national epidemiologic data and disability weights, and explored associated problems and uncertainties. METHODS: We combined data from Dutch vital statistics, registrations, and surveys with Dutch disability weights to calculate disease-specific health loss in DALYs, which are the sum of years of life lost (YLLs) and years lived with disability (YLDs) weighted for severity. RESULTS: YLLs were primarily lost by cardiovascular diseases and cancers, while YLDs were mostly lost by mental disorders and a range of chronic somatic disorders (such as chronic nonspecific lung disease and diabetes). These 4 diagnostic groups caused approximately equal numbers of DALYs. Sensitivity analysis calls for improving the accuracy of the epidemiologic data in connection with disability weights, especially for mild and frequent diseases. CONCLUSIONS: The DALY approach appeared to be feasible at a national Western European level and produced interpretable results, comparable to results from the Global Burden of Disease Study for the Established Market Economies. Suggestions for improving the methodology and its applicability are presented.

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References

1997Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study 1997Mortality by cause for eight regions of the world: Global Burden of Disease Study 1986The Fourth Stage of the Epidemiologic Transition: The Age of Delayed Degenerative Diseases 1997Regional patterns of disability-free life expectancy and disability-adjusted life expectancy: Global Burden of Disease Study 1991Trading Off Longer Life for Worsening Health

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