Sabgayda T.P.¹, Protasova N.P.² Artuchov I.P.^3
1 Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow
² Ministry of Health of the Krasnoyarsk Territory
³ V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk.

Abstract. WHO recommends to use DALY for determining population health status, however, the Russian data are not sufficient to calculate it. A simplified calculation method doesn’t provide for the expected results, which makes it relevant to search for ways to adapt the methodology for calculating DALY without its simplification.

The purpose of the study was to adapt DALY calculation methods to assess health loss related to nonfatal cardiovascular diseases.

Database of compulsory health insurance fund for residents of Krasnoyarsk seeking care in clinics and in hospitals was used. The length of cardiovascular diseases was assumed to be one year for outpatient and 15 days for hospital patients. Evaluation of the parameters' values for age weighting function was conducted during the study. Disability weight was taken to be 0.92 for all hospitalized patients. Adaptation of the DALY calculation method was carried out by determining parameters values of the original equation. The structure of cause and the age structure of patients as well as the average age of hospitalized patients by groups with different outcomes were calculated to determine the parameters values. On the basis of the adapted method we calculated the age and disease structure of health loss in outpatient and inpatient patients. Also, health loss due to morbidity and mortality were compared.

Conclusions. To estimate burden of disease of the Russian population it is advisable to use the adapted methodology for calculating DALY, wherein: the constant and parameter from the age weighting are C = 0.10 and β = 0.03; age weighting modulation factor K = 0.104; discount rate r = 0,03; life expectancy corresponds to 80 years for men and 87 years for women.

The algorithm for calculating the burden of cardiovascular diseases due to nonfatal health problems is not the same for different diseases and their groups. In some cases, age-adjusted disability weight should be set, and in other cases it is possible to use an average value for all age groups of patients. To prolong the employment period it is necessary to improve health promotion activities to reduce the excess health loss due to diseases of the circulatory system in age group 55-59. Methods of care delivery to patients with hypertension should be improved as well with a special focus on prevention among young men.

Keywords. Disability-Adjusted Life Years; years lost due to disability; burden of diseases of the circulatory system; age weighting of a year of healthy life; disability weight; discount rate for value of one year of healthy life; comparability of data on morbidity and mortality.

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