Disability-adjusted life year
Disability-adjusted life years (DALYs) are a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability, or early death. It was developed in the 1990s as a way of comparing the overall health and life expectancy of different countries.
DALYs have become more common in the field of public health and health impact assessment (HIA). They include not only the potential years of life lost due to premature death but also equivalent years of 'healthy' life lost by virtue of being in states of poor health or disability. In so doing, mortality and morbidity are combined into a single, common metric.[2]
Economic applications[edit]
The methodology is not an economic measure. It measures how much healthy life is lost. It does not assign a monetary value to any person or condition, and it does not measure how much productive work or money is lost as a result of death and disease. However, HALYs, including DALYs and QALYs, are especially useful in guiding the allocation of health resources as they provide a common numerator, allowing for the expression of utility in terms of dollar/DALY, or dollar/QALY.[14] For example, in Gambia, provision of the pneumococcal conjugate vaccine costs $670 per DALY saved.[19] This number can then be compared to other treatments for other diseases, to determine whether investing resources in preventing or treating a different disease would be more efficient in terms of overall health.
History and usage[edit]
Originally developed by Harvard University for the World Bank in 1990, the World Health Organization subsequently adopted the method in 1996 as part of the Ad hoc Committee on Health Research "Investing in Health Research & Development" report. The DALY was first conceptualized by Christopher J. L. Murray and Lopez in work carried out with the World Health Organization and the World Bank known as the Global Burden of Disease Study, which was undertaken in 1990.[23] It is now a key measure employed by the United Nations World Health Organization in such publications as its Global Burden of Disease.[24]
The DALY was also used in the 1993 World Development Report.[25]: x