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Do death or DALYs matter more?
When talking about the efficacy of what we spend on our health, the most frequently cited statistic is mortality rates. Many of us assume that a top notch healthcare system diminishes when and how we die. As a result, we could delegate the most time and money to the top ranked causes of death.
In the following ranking of the causes of deaths globally, we can see that ischemic heart disease is #1, malaria #11 and falls are #22.
From: IHME University of Washington
Perhaps, though, we would be better off if we targeted spending toward how we live.
DALYs
And that takes us to Disability Adjusted Life Years. From a DALY perspective, we should focus our time and money on the disease, depression, disfigurement and other disabilities that detract from our quality of life. So even if we live until 80, counting DALYs, it could be less. Someone who is struck by paralysis at 58 and dies 20 years later has lost 50 percent of those 20 years because of suffering–or 10 DALYs.
Below, the DALYs top 25 list is somewhat different from the top causes of death. Heart disease remains #1 but malaria moves up to the #6 slot, falls are at #19, and neck pain has now been added to the chart.
From: IHME University of Washington
As you can see, if we want to diminish the DALYs we lose from suffering instead of mortality rates for certain diseases, our time and money might need to be redirected.
Our Bottom Line: Healthcare Spending Tradeoffs
Thinking economically, we know that our limited resources mean spending more time and money on one goal leaves less for something else. Whether considering a DALY approach or other alternatives, we have healthcare spending tradeoffs we need to identify.
