Kobyakova O.S.¹, Deyev I.A.¹, Boikov V. A.¹, Milkevich M.N.², Kulikov E.S.¹, Naumov A.O.², Golubeva A.A.¹, Shibalkov I.P.^3
1 Siberian State Medical University, Tomsk
² Bureau of Medical Statistic, Tomsk
³ National Research Tomsk Polytechnic University, Tomsk

Contacts: Vadim A. Boykov, å-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Abstract. Intensified globalization in all spheres of life and on-going integration of the Russian Federation into the global economy, as well adverse (in comparison with the developed countries) health status of the population, actualize issues related to analysis and possible application of foreign healthcare theories and methods within the context of local environment. The study relevance is also supported by the fact that the existing methods of public health evaluation (mortality, morbidity) fail adequately evaluate effectiveness of current government policy. Such evaluation requires use of indicators that fully reflect policy impact on health status of the population.

Today, DALY (Disability Adjusted Life Years) is one of the most popular and frequently used in different countries methods of comprehensive health assessment, which was developed by the World Bank in cooperation with the World Health Organization.

In view of the above, the purpose of this work is to analyze possibility of using DALY to assess health status of population of the Russian Federation as well as effectiveness of care delivery management. To achieve these goals, the authors studied practices of using DALY in foreign countries in management and research.

Results and conclusions. DALY are calculated at a specific point in time and represents difference between the amount of health provided by a defined population at this point of time, and impact of all negative effects that reduce health. DALY has been widely and successfully used for objective evaluation of health systems’ performance in some foreign countries. Currently, the Russian Federation has all necessary conditions to calculate DALY for the entire country, and for each region and municipality.

Use of DALY along with demographic and economic indicators would help to set more accurate priorities for developing healthcare system at the federal and regional levels and to evaluate effectiveness of activities implemented by state authorities in health protection. Furthermore, calculation of DALY in dynamics allows to estimate population effects related to both medical technologies and exposure to economic, social, environmental, urban, and other risk factors.

Keywords: Assessment of population health; DALY; demography.

References

1. Adeyi O., Smit O., Robles S. Gosudarstvennaya politika i problema khronicheskikh neinfektsionnykh zabolevaniy [Public policy and the problem of chronic non-communicable diseases]. [Transl. from Eng.]. Moscow: Ves' mir; 2008. 211 p.(In Russian)
2. Gosudarstvennaya programma Rossiyskoy Federatsii «Razvitie zdravookhraneniya» [“Health care development”, the government program of the Russian Federation]. Postanovlenie Pravitel'stva RF ot 15.04.2014 g. ¹ 294. [Online] [cited 2015 Feb 10]. Available from: http://base.garant.ru/70643470/ .(In Russian)
3. Ermakov S.P. Prognoz poter' let zdorovoy zhizni naseleniya RF. [Prognosis for losses of healthy life years in RF population]. Moscow: Palmarium Academic Publishing; 2013. 396 p. .(In Russian)
4. Kobyakova O.S., Deev I.A., Nesvetaylo N.Ya., Boykov V.A., Shibalkov I.P. Chislo poteryannykh let zhizni (DALY) v rezul'tate prezhdevremennoy smertnosti naseleniya Tomskoy oblasti v 2012 g. [The number of life years lost (DALY) resulted from premature mortality in population of Tomsk region in 2012]. Vestnik RAMN 2013;(11):60-64. .(In Russian)
5. Kobyakova O.S., Deev I.A., Nesvetaylo N.Ya., Boykov V.A., Shibalkov I.P., Naumov A.O., et al. Chislo poteryannykh let zhizni (DALY) v rezul'tate prezhdevremennoy smertnosti detskogo naseleniya Tomskoy oblasti v 2012 g.[The number of life years lost (DALY) resulted from premature mortality in children population of Tomsk region in 2012]. Meditsina v Kuzbasse 2013;(4):47-52. .(In Russian)
6. Ob osnovakh okhrany zdorov'ya grazhdan v Rossiyskoy Federatsii: federal'nyy zakon ot 21.11.2011 ¹ 323-FZ (s izmeneniyami i dopolneniyami) [On the basis of population health protection in the Russian Federation]. [Online] [cited 2015 Feb 10]. Available from: http://base.garant.ru/12191967/ .(In Russian)
7. Ob utverzhdenii statisticheskogo instrumentariya dlya organizatsii Ministerstvom zdravookhraneniya Rossiyskoy Federatsii federal'nogo statisticheskogo nablyudeniya za deyatel'nost'yu uchrezhdeniy sistemy zdravookhraneniya [On approval of statistical toolkit to provide the statistical monitoring of activity of health care institutions by the ministry of Health of the Russian Federation]. Prikaz Rosstata ot 14.01.2013 ¹ 13. [Online] [cited 2015 Feb 10]. Available from: http://docs.pravo.ru/document/view/29805107/30537145/ .(In Russian)
8. Otchet po chelovecheskomu razvitiyu 1994 [Report on human development]. New York: Oksford Yuniversiti Press; 1994. 226 p. (In Russian)
9. Rostovtsev V.N., Lomat' L.N., Ryabkova O.I., Marchenkova I.B., Kuz'menko V.E. Metodika kompleksnoy otsenki poter' zdorov'ya v rezul'tate zabolevaemosti i smertnosti. Instruktsiya po primeneniyu [Methods of complex assessment of health losses caused by population morbidity and mortality]. Minsk; 2008. .(In Russian)
10. Uyba V.V. Ekonomicheskie metody upravleniya v zdravookhranenii [Economic methods of management in health care]. Novosibirsk: OOO «Al'fa-Resurs»; 2012. 314 p. .(In Russian)
11. Shishkin S.V., Ermakov S.P., Kakorina E.P., Popovich L.D, Frid E.D., Sheyman I.M. Metodika otsenki effektivnosti funktsionirovaniya territorial'nykh sistem zdravookhraneniya v Rossiyskoy Federatsii [Methods for assessing the activity efficiency of regional healthcare systems in the Russian Federation] . Moscow: 2007. 64 p. .(In Russian)
12. Allotey P, Reidpath D, Kouamé A, Cummins R. The DALY, context and the determinants of the severity of disease: an exploratory comparison of paraplegia in Australia and Cameroon [Online]. National Center for Biotechnology Information 2014 [cited 2015 Feb 10]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/12850119
13. Brown DW. Economic value of disability-adjusted life years lost to violence: estimates for WHO Member States [Online]. National Center for Biotechnology Information 2014 [cited 2015 Feb 10]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/19115548
14. Chen RJ, Chen BH, Kan HD. Application of disability adjusted life years in evaluating health effects due to particulate air pollution in Chinese cities [Online]. National Center for Biotechnology Information 2014 [cited 2015 Feb 10]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/20388335
15. Costilla R, Tobias M, Blakely T. The burden of cancer in New Zealand: a comparison of incidence and DALY metrics and its relevance for ethnic disparities [Online]. National Center for Biotechnology Information 2014 [cited 2015 Feb 10]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/23731103
16. Drake T. Priority setting in global health: towards a minimum DALY value [Online]. National Center for Biotechnology Information 2014 [cited 2015 Feb 10]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/23576492
17. Ferrari AJ, Norman RE, Freedman G, Baxter AJ, Pirkis JE, et al. The Burden Attributable to Mental and Substance Use Disorders as Risk Factors for Suicide: Findings from the Global Burden of Disease Study 2010. PLoS ONE 2014; 9(4).
18. Homedes N. The Disability-Adjusted Life Year (DALY) Definition, Measurement and Potential Use [Online]. 2014 [cited 2015 Feb 10]; Available from: http://pubhealth.spb.ru/COPC/DALY.htm
19. Institute for Health Metrics and Evaluation. Data Visualizations. [Online]. 2014 [cited 2015 Feb 10]; Available from: http://viz.healthmetricsandevaluation.org/gbd-compare/
20. Krishnamoorthy K, Harichandrakumar KT, Krishna Kumari A, Das LK. Burden of chikungunya in India: estimates of disability adjusted life years (DALY) lost in 2006 epidemic [Online]. National Center for Biotechnology Information 2014 [cited 2015 Feb 10]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/19326705
21. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; (380): 2224–2260.
22. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; (380): 2095–2128.
23. Mangen MJ, Plass D, Havelaar AH, Gibbons CL, Cassini A, Mühlberger N, van Lier A, Haagsma JA, Brooke RJ, Lai T, de Waure C, Kramarz P, Kretzschmar ME; BCoDE consortium. The pathogen- and incidence-based DALY approach: an appropriate [corrected] methodology for estimating the burden of infectious diseases [Online]. National Center for Biotechnology Information 2014 [cited 2015 Feb 10]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/24278167
24. Murray CJ, Ezzati M, Flaxman AD, et al. GBD 2010: design, definitions, and metrics. Lancet 2012; (380): 2063–6.
25. Murray CJL, Lopez AD, editors (1996) The Global Burden of Disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank ; Distributed by Harvard University Press.
26. Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; (380): 2197–2223.
27. Murray CJL. Rethinking DALYs. In: Murray CJL, Lopez AD, eds. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, Harvard University Press; 1996:1–98.
28. Salomon JA, Vos T, Hogan DR, Gagnon M, Naghavi M, et al. Common values in assessing health outcomes from disease and injury:disability weights measurement study for the Global Burden of Disease 2010 Lancet 2012; (380): 2129–2143.
29. Salomon JA, Wang H, Freeman MK, Vos T, Flaxman AD, et al. Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden Disease Study 2010. Lancet 2012; (380): 2144–2162.
30. Sassi F., Archard L., Le Grand J. Equity and the economic evaluation of healthcare. Health Technology Assessment 2001; (5):1–138.
31. Schopper D, Pereira J, Torres A, Cuende N, Alonso M, Baylin A, Ammon C, Rougemont A. Estimating the burden of disease in one Swiss canton: what do disability adjusted life years (DALY) tell us? [Online]. National Center for Biotechnology Information 2014 [cited 2015 Feb 10]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/11034971
32. The Global Burden of Disease 2004 update. WHO: Library Cataloguing-in-Publication Data; 2008. 160 p.
33. The global burden of disease: generating evidence, guiding police. Institute for health metrics and evaluation. University of Washington [Online]. 2014 [cited 2015 Feb 10]; Available from: http://www.healthmetricsandevaluation.org/gbd/publications/policy-report/global-burden-disease-generating-evidence-guiding-policy
34. Tukov AR, Shafranskii IL. Evaluating relative risk of morbidity or mortality for persons who participated in the clean-up of the Chernobyl accident (based on the DALY index) [Online]. National Center for Biotechnology Information 2014 [cited 2015 Feb 10]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/11270147
35. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; (380): 2163–96.
36. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; (380): 2163–2196.
37. Wang H, Dwyer-Lindgren L, Lofgren KT, Rajaratnam JK, Marcus JR, et al. Age-specifi c and sex-specifi c mortality in 187 countries, 1970–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; (380): 2071–2094.
38. World Development Report: Investing in Health. Washington: World Bank; 1993.
39. World Health Organization (2008). The Global Burden of Disease; 2004 update. Switzerland.
40. World Health Organization. Health statistics and information systems. [Online]. WHO 2014 [cited 2015 Feb 10]; Available from: http://www.who.int/healthinfo/global_burden_disease/tools_software/en/
41. Zhou SC, Cai L, Wang J, Cui SG, Chai Y, Liu B, Wan CH. Measuring the burden of disease using disability-adjusted life years in Shilin County of Yunnan Province, China [Online]. National Center for Biotechnology Information 2014 [cited 2015 Feb 10]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/21431803

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