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. 2000 Aug;90(8):1241–1247. doi: 10.2105/ajph.90.8.1241

A national burden of disease calculation: Dutch disability-adjusted life-years. Dutch Burden of Disease Group.

J M Melse 1, M L Essink-Bot 1, P G Kramers 1, N Hoeymans 1
PMCID: PMC1446331  PMID: 10937004

Abstract

OBJECTIVES: This study estimated the burden of disease due to 48 major causes in the Netherlands in 1994 in disability-adjusted life-years (DALYs), using national epidemiologic data and disability weights, and explored associated problems and uncertainties. METHODS: We combined data from Dutch vital statistics, registrations, and surveys with Dutch disability weights to calculate disease-specific health loss in DALYs, which are the sum of years of life lost (YLLs) and years lived with disability (YLDs) weighted for severity. RESULTS: YLLs were primarily lost by cardiovascular diseases and cancers, while YLDs were mostly lost by mental disorders and a range of chronic somatic disorders (such as chronic nonspecific lung disease and diabetes). These 4 diagnostic groups caused approximately equal numbers of DALYs. Sensitivity analysis calls for improving the accuracy of the epidemiologic data in connection with disability weights, especially for mild and frequent diseases. CONCLUSIONS: The DALY approach appeared to be feasible at a national Western European level and produced interpretable results, comparable to results from the Global Burden of Disease Study for the Established Market Economies. Suggestions for improving the methodology and its applicability are presented.

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Selected References

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  1. Barendregt J. J., Bonneux L., Van der Maas P. J. DALYs: the age-weights on balance. Bull World Health Organ. 1996;74(4):439–443. [PMC free article] [PubMed] [Google Scholar]
  2. Havelaar A. H., De Hollander A. E., Teunis P. F., Evers E. G., Van Kranen H. J., Versteegh J. F., Van Koten J. E., Slob W. Balancing the risks and benefits of drinking water disinfection: disability adjusted life-years on the scale. Environ Health Perspect. 2000 Apr;108(4):315–321. doi: 10.1289/ehp.00108315. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Hyder A. A., Rotllant G., Morrow R. H. Measuring the burden of disease: healthy life-years. Am J Public Health. 1998 Feb;88(2):196–202. doi: 10.2105/ajph.88.2.196. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Morrow R. H., Bryant J. H. Health policy approaches to measuring and valuing human life: conceptual and ethical issues. Am J Public Health. 1995 Oct;85(10):1356–1360. doi: 10.2105/ajph.85.10.1356. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Murray C. J., Lopez A. D. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997 May 24;349(9064):1498–1504. doi: 10.1016/S0140-6736(96)07492-2. [DOI] [PubMed] [Google Scholar]
  6. Murray C. J., Lopez A. D. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997 May 17;349(9063):1436–1442. doi: 10.1016/S0140-6736(96)07495-8. [DOI] [PubMed] [Google Scholar]
  7. Murray C. J., Lopez A. D. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet. 1997 May 3;349(9061):1269–1276. doi: 10.1016/S0140-6736(96)07493-4. [DOI] [PubMed] [Google Scholar]
  8. Murray C. J., Lopez A. D. Regional patterns of disability-free life expectancy and disability-adjusted life expectancy: global Burden of Disease Study. Lancet. 1997 May 10;349(9062):1347–1352. doi: 10.1016/S0140-6736(96)07494-6. [DOI] [PubMed] [Google Scholar]
  9. Murray C. J., Lopez A. D. The utility of DALYs for public health policy and research: a reply. Bull World Health Organ. 1997;75(4):377–381. [PMC free article] [PubMed] [Google Scholar]
  10. Olshansky S. J., Ault A. B. The fourth stage of the epidemiologic transition: the age of delayed degenerative diseases. Milbank Q. 1986;64(3):355–391. [PubMed] [Google Scholar]
  11. Richardson J., Nord E. The importance of perspective in the measurement of quality-adjusted life years. Med Decis Making. 1997 Jan-Mar;17(1):33–41. doi: 10.1177/0272989X9701700104. [DOI] [PubMed] [Google Scholar]
  12. Sayers B. M., Fliedner T. M. The critique of DALYs: a counter-reply. Bull World Health Organ. 1997;75(4):383–384. [PMC free article] [PubMed] [Google Scholar]
  13. Williams A. Calculating the global burden of disease: time for a strategic reappraisal? Health Econ. 1999 Feb;8(1):1–8. doi: 10.1002/(sici)1099-1050(199902)8:1<1::aid-hec399>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  14. de Hollander A. E., Melse J. M., Lebret E., Kramers P. G. An aggregate public health indicator to represent the impact of multiple environmental exposures. Epidemiology. 1999 Sep;10(5):606–617. [PubMed] [Google Scholar]

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