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Disability weights for diseases in Europe

Objective

Objectives:
The programme aims at exploring the full potential of disability weighting. The project aims at, firstly, establishing a comprehensive list of the disability weights associated with the various diseases that constitute the major part of the burden of disease in Europe; secondly, to improve, refine, and validate the methodology to estimate the disability weights; and thirdly, to investigate the cross-national stability of the disability weights (and interpreting the differences, if found). Finally, burden-of-disease estimates per country for a number of diseases will be computed and compared (provided that available incidence and mortality data are similar to an acceptable degree in the participating countries). The potential value of combining disease-specific morbidity and mortality data has been illustrated recently by Murray and Lopez' Global Burden of Disease Study.

Background:
The health situation in populations has traditionally been assessed on the basis of mortality data. In developed countries, which are characterized by very low mortality rates in the younger age-groups and a high prevalence of chronic and disabling conditions in the older age-groups, there is a need to supplement information on the population's life expectancy with morbidity data. In recent years considerable progress has been made in developing true public health measures, such as Health Expectancy, that incorporate mortality and morbidity. The work of Murray et al on the Global Burden of Disease (GBD) is another promising development. Their work, which was first published in the World Bank's report 'Investing in Health' in 1993, resulted in a comprehensive set of estimates for the global and regional burden of disease resulting from premature mortality and disability. Burden of disease was quantified in DALYs, e.g. disability adjusted life years, lost due to death, disease or injury. The GBD project has illustrated the potential of combining disease-specific morbidity and mortality data in one comprehensive measure. The combination in one single outcome measure of both length of life and the level of disability during life-years allows for guidance of policy-making, priority-setting and planning in health services research and in health care, including preventive, curative and rehabilitation interventions. Such a true 'public health' approach does however require careful standardization and broad support for the weights attributed to the different levels of disability.

Objectives:
The current research proposal aims at exploring the full potential of disability weighting. The project aims at, firstly, establishing a comprehensive list of the disability weights associated with the various diseases that constitute the major part of the burden of disease in Europe; secondly, to improve, refine, and validate the methodology to estimate the disability weights; and thirdly, to investigate the cross cultural stability of the disability weights (and interpreting the differences, if found).

Finally, burden-of disease estimates per country for a number of diseases that constitute major public health problems in Europe will be computed and compared (provided that available incidence and mortality data are similar to an acceptable degree in the participating countries).

Work plan:
The work content of the current research proposal is divided into three stages. First, a comprehensive and consistent list of diseases that constitute the major part of ill health in Western Europe will be made. Each disease will then be subdivided into homogenous clinical stages. The health status associated with each disease stage will be described in as standardised manner. All together, this list will be the input for the weighting procedure. Next, the standardized weighting protocol will be applied in each of the participating countries. A number of studies on reliability and validity of the methodology will be conducted as side-studies to the weighting protocol. The third phase of the project consists of an international comparison of the weights obtained in the participating countries, burden of disease estimates for at least three major diseases in each of the countries and an international comparison of these burden of dis.

Keywords (max 10): disability weighting, health indicators, public health, burden of disease, DALY, Disability Adjusted Life Expectancy, standardization, cross-national comparison.07 07

Funding Scheme

CON - Coordination of research actions

Coordinator

ERASMUS UNIVERSITEIT ROTTERDAM
Address

3000 DR Rotterdam
Netherlands