The economic burden of disease by industry: Differences in quality-adjusted life years and associated costs

Chapter 5 discusses the use of epidemiology to identify the source of public health problems and inform policymaking. It uses a case study to illustrate how researchers, policymakers, and practitioners detect diseases, identify their sources, determine the extent of an outbreak, and prevent new infections. The chapter also defines key measures in epidemiology that can indicate public health priorities, including morbidity and mortality, years of potential life lost, and measures of lifetime impacts, including disability-adjusted life years and quality-adjusted life years. Finally, the chapter reviews epidemiological study designs, differentiating between experimental and observational studies, to show how to interpret data and identify limitations.

Download Full-text

Comment on article by Palazzuolo et al.: Total knee arthroplasty improves the quality-adjusted life years in patients who exceeded their estimated life expectancy

International Orthopaedics ◽

10.1007/s00264-021-05016-2 ◽

2021 ◽

Author(s):

Hui-hui Sun ◽

Wang-xin Liu ◽

Zhi-cheng Pan ◽

Wei-feng Ji

Keyword(s):

Total Knee Arthroplasty ◽

Life Expectancy ◽

Knee Arthroplasty ◽

Quality Adjusted Life Years ◽

Life Years ◽

Total Knee ◽

Quality Adjusted Life

Download Full-text

Medicare’s Hospital Value-Based Purchasing Program Values Quality over QALYs

Medical Decision Making ◽

10.1177/0272989x211017105 ◽

2021 ◽

pp. 0272989X2110171

Author(s):

Edward C. Norton ◽

Jun Li ◽

Anup Das ◽

Andrew M. Ryan ◽

Lena M. Chen

Keyword(s):

Quality Of Care ◽

Pay For Performance ◽

Health Interventions ◽

Quality Adjusted Life Years ◽

Value Based Purchasing ◽

Quality Performance ◽

Life Years ◽

Policy Adjustments ◽

Quality Adjusted Life

Medicare’s Hospital Value-Based Purchasing Program (HVBP) is the first national pay-for-performance program to combine measures of quality of care with a measure of episode spending. We estimated the implicit tradeoffs between mortality reduction and spending reduction. To earn points in HVBP, a hospital can either lower mortality or reduce spending, creating a tradeoff between the 2 measures. We analyzed the quality performance and earned points of 2814 hospitals using publicly available data. We then quantified the tradeoffs between spending and mortality in terms of quality-adjusted life-years (QALYs). If incentives in the program were balanced, then the tradeoff between spending and QALYs should be comparable with those of high-value health interventions, roughly $50,000 to $200,000 per QALY. Instead, the tradeoff in HVBP was about $1.2 million per QALY. HVBP overvalues improvements in quality of care relative to spending reductions. We propose 2 possible policy adjustments that could improve incentives for hospitals to deliver high-value care.

Download Full-text

Good, Fairness and QALYs

Royal Institute of Philosophy Lecture Series ◽

10.1017/s0957042x00003874 ◽

1988 ◽

Vol 23 ◽

pp. 57-73 ◽

Cited By ~ 1

Author(s):

John Broome

Keyword(s):

Health Service ◽

Quality Adjusted Life Years ◽

Life Years ◽

Quality Adjusted Life

Counting QALYs (quality adjusted life years) has been proposed as a way of deciding how resources should be distributed in the health service: put resources where they will produce the most QALYs. This proposal has encountered strong opposition. There has been a disagreement between some economists favouring QALYs and some philosophers opposing them. But the argument has, I think, mostly been at cross-purposes. Those in favour of QALYs point out what they can do, and those against point out what they can't. There need be no disagreement about this. What is needed is to sort out what is the proper domain of QALYs, and it may be possible to do this amicably. Then we may be able to get on with the more useful job of deciding how well QALYs perform within their domain. In this paper I shall try to accomplish the first task (sections II–IV), and make a start on the second (sections V–VIII).

Download Full-text