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T7 - Burden of Disease Part 2

There are several approaches used to assess the burden of illness, including prevalence, direct and indirect costs, and impact on resources. Prevalence measures the number affected at a point in time and is used to estimate healthcare needs and costs. The cost of coronary artery disease in the UK was estimated at £8.5 billion annually using prevalence data. Asthma affects over 5 million people in the UK and costs over £850 million each year to treat. Disability-adjusted life years (DALYs) and quality-adjusted life years (QALYs) also measure burden by quantifying years of life lost to illness or disability.

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5 views22 pages

T7 - Burden of Disease Part 2

There are several approaches used to assess the burden of illness, including prevalence, direct and indirect costs, and impact on resources. Prevalence measures the number affected at a point in time and is used to estimate healthcare needs and costs. The cost of coronary artery disease in the UK was estimated at £8.5 billion annually using prevalence data. Asthma affects over 5 million people in the UK and costs over £850 million each year to treat. Disability-adjusted life years (DALYs) and quality-adjusted life years (QALYs) also measure burden by quantifying years of life lost to illness or disability.

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hdddissa2005
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Part 2

Dr. Omnia Elmahdy


There are a number of approaches and indicators
used to assess the burden of illness

Dr Omnia Elmahdy 2
Approach 1
The prevalence of a disease is used to estimate the
costs for that disease during a period of time
(Direct and Indirect costs)

Prevalence is a measure of the burden of disease in a


population in a given location and at a particular
time, as represented in a count of the number of
people affected, which is required to plan
appropriately for their health care needs.
Dr Omnia Elmahdy 3
Dr Omnia Elmahdy 4
Calculate : the point prevalence????

Dr Omnia Elmahdy 5
The cost of coronary artery disease in the UK was estimated
by using the number of prevalent cases and data relating to

mortality, morbidity and health service utilization. +

In addition, a societal perspective was employed by including


both direct and productivity costs.

The direct health care costs were


estimated at £1.8 billion and the
productivity costs of the disease
were estimated at £6.7 billion.
Dr Omnia Elmahdy 6
Another example is taken from the condition asthma
and its management.
In a study, it was estimated that 5.1 million people of all
ages and social backgrounds were being treated for
asthma in the UK (including 1.4 million children under
16 years of age) at a total annual cost to the UK health
care system of over £850 million.

Dr Omnia Elmahdy 7
However, it is not the costs directly related to treatment
that contribute the largest proportion to overall cost, but
rather the costs of inappropriate treatments and non-
compliance ‫ عدم االلتزام بالعالج‬that result in suboptimal
control ‫ تحكم ضعيف بالمرض‬and an excessive number of
attacks resulting in hospitalizations.

Dr Omnia Elmahdy 8
Approach 2
Another method employed has been to calculate the
impact of disease on resources
(Cost of appointment time, cost of GPs time for the
illness, cost of resources utilized for the illness)

Dr Omnia Elmahdy 9
Example
• In a US study (2016) on 7820 eligible asthma adult
patients, well-controlled asthma (Asthma Control
Test, ACT score 20–25) compared with partly
controlled (ACT score 16–19) or poorly controlled
asthma (ACT score≤15)

Dr Omnia Elmahdy 10
Approach 3
The WHO approach to estimating the burden of disease
is to calculate the impact of illness on disability-adjusted
life years (DALYs) and quality-adjusted life years (QALYs)

Dr Omnia Elmahdy 11
(Disability Adjusted Life Years)

Dr Omnia Elmahdy 12
Dr Omnia Elmahdy 13
It can be used of as a measurement of the gap between
current health status and an ideal health situation where
the entire population lives to an advanced age, free of
disease and disability.

Dr Omnia Elmahdy 14
Example

A DIABETIC person dies at the age of 60 years


with a life expectancy of 75 years. He had, due to
diabetes complications, lived with 50% disability for
the last 10 years of his life.

Calculate DALY?

Dr Omnia Elmahdy 15
Dr Omnia Elmahdy 16
Dr Omnia Elmahdy 17
QALY (Quality Adjusted Life Years)

• A quality-adjusted life-year (QALY) takes into


account both the quantity and quality of life
generated by healthcare interventions.

• It is the arithmetic product of life expectancy and a


measure of the quality of the remaining life-years.

Dr Omnia Elmahdy 18
A year of perfect health is worth 1 and a year of less than perfect
health is worth less than 1. Death is considered to be equivalent
to 0.

QALYs provide a common measure to assess the extent of the


benefits gained from a variety of interventions in terms of health

related quality of life and survival for the patient, and if these

interventions generate a year of perfect health (one QALY).

Dr Omnia Elmahdy 19
Dr Omnia Elmahdy 20
Comparisons can be made between interventions, and priorities
can be established based on those interventions that are relatively
inexpensive (low cost per QALY) and those that are relatively
expensive (high cost per QALY).

Dr Omnia Elmahdy 21
Standard gamble method: respondents choose between
remaining in ill health for a specific period of time or
medical intervention that could restore them to perfect
health or kill them.

Dr Omnia Elmahdy 22

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