健康预期寿命与伤残调整生命年内在关联与差异

Inherent relationship and difference between healthy life expectancy and disability adjusted life year

健康预期寿命(HLE)与伤残调整生命年(DALY)同时关注人群死亡和非致死性健康效应,均为国民生命质量的综合性测度指标,其关联性和差异性的比较分析有利于人群健康测量的学科交叉研究,开阔学术视野。从广义上看,这2种健康测量指标均为对健康概念的延展,均需要一个标准生命表作为测量的基础。HLE反映的是良性健康水平,关注纯粹健康状态的生存时间及其社会学后果;而DALY反映负面健康水平,关注疾病分类系统下疾病类型及单一病种的流行病学和经济学后果。HLE主要侧重功能性、体验性指标,但对传染性疾病、精神障碍性疾病的健康后果测量不敏感,而DALY的研究成果对此具有重要的借鉴意义。2种指标的测量均从多方面影响到公共健康政策、测量所隐含的社会伦理价值、公共资源配置决策和资源分配公平问题等。

Healthy life expectancy(HLE)and disability adjusted life year(DALY)focus on both mortality and non-fatal health effects,which are comprehensive measures of national life quality.It is beneficial to the interdisciplinary research of population health measurement to broaden the academic horizon.In a broad sense,both of the two healthy indicators extend the healthy concept and need a standard life table as the basis of measurement.HLE reflects health level and focuses on the survival time of pure health state and its sociological consequences.DALY reflects negative health levels and focuses on the epidemiological consequences of disease types and single disease under the disease classification system.HLE is mainly focused on functional and experiential indicators,but it is insensitive to the measurement of healthy consequences of infectious disease and mental disorders;however,the research results of DALY are significant for reference.The measurement of the two indexes affect the public health policy from many aspects,including the implied social ethical value,the decision of public resource allocation and the equity of resource allocation.