OK, time I dived into health economic terms!
Details #
DALYs are an extension of QALYs: Quality Adjusted Life Years and beg the questions that attach to QALYs but I can give a simple definition of DALYs and get into the details and issues in a bigger entry to come for QALYs!
QALYs, like DALYs, are what they sound like and to me they feel as if they came out of issues around oncology back when I was briefly there in the early 1980s. Then there was a growing recognition that the toxicities of much chemotherapy and radiotherapy, and the consequences of major surgery, were all so severe that some patients felt the life they were, statistically, gaining, was hugely devalued by the loss of quality of life. Equally of course, there had been an issue for years that only looking at mortality and life expectancy in medicine missed the whole vital area of quality of life.
So a QALY is what it says: if one’s quality of life is less than 100% (you can see at least one catch coming) then the years gained by an intervention are rated as less than a year per year. If say quality of life is rated as only 50% of normal then for each year that an intervention gives (statistically again) then the QALY gain is on half a year not one year.
DALYs are a measure of the impact of a condition: they are the number of years lost (YLL: Years of Life Lost) which might have been lived with normal quality of life, plus the number of years that are lived but with reduced quality of life (YLD: Years Lived with Disability).
DALY = YLL + YLD
The years lived with disability (YLD) are weighted using a QALY style weighting. So if ten years are lived but with only 50% of normal quality of life then the YLD is five years, not ten.
I have yet to see the DALY terminology applied to psychological distress, dysfunction and reduced well-being, but I am sure that within health economic realms the DALY and YLL and YLD ideas are being used for our domains and health economics has of course become a politically dominant framework when addressing questions of resource allocation.
Try also #
Health economics
QALYs
Statistical versus individual prognoses
Chapters #
Not covered in the OMbook.
Online resources #
None forseeable.
Dates #
First created 16.xii.24.
