文章基本信息

标题：Disability weights for comorbidity and their influence on Health-adjusted Life Expectancy
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作者：Pieter HM van Baal ; Nancy Hoeymans ; Rudolf T Hoogenveen 等
期刊名称：Population Health Metrics
印刷版ISSN：1478-7954
电子版ISSN：1478-7954
出版年度：2006
卷号：4
期号：1
页码：1
DOI：10.1186/1478-7954-4-1
语种：English
出版社：BioMed Central
摘要：Comorbidity complicates estimations of health-adjusted life expectancy (HALE) using disease prevalences and disability weights from Burden of Disease studies. Usually, the exact amount of comorbidity is unknown and no disability weights are defined for comorbidity. Using data of the Dutch national burden of disease study, the effects of different methods to adjust for comorbidity on HALE calculations are estimated. The default multiplicative adjustment method to define disability weights for comorbidity is compared to HALE estimates without adjustment for comorbidity and to HALE estimates in which the amount of disability in patients with multiple diseases is solely determined by the disease that leads to most disability (the maximum adjustment method). To estimate the amount of comorbidity, independence between diseases is assumed. Compared to the multiplicative adjustment method, the maximum adjustment method lowers HALE estimates by 1.2 years for males and 1.9 years for females. Compared to no adjustment, a multiplicative adjustment lowers HALE estimates by 1.0 years for males and 1.4 years for females. The differences in HALE caused by the different adjustment methods demonstrate that adjusting for comorbidity in HALE calculations is an important topic that needs more attention. More empirical research is needed to develop a more general theory as to how comorbidity influences disability.
关键词：Adjustment Method ; Disability Weight ; Disease Pair ; Disability Increase ; Multiplicative Adjustment