Summarizing Population Health Directions for the Development and Application of Population Metrics (1998) / Chapter Skim
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Conclusions
Conclusions
Pages 5-16
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From page 5... ...
Work to clarify terminology is one element covered by the committee's recommendation about standard setting. CONCLUSIONS The committee's conclusions and recommendations are intended to provide general rather than detailed perspectives and directions for the future development and application of summary measures of population health.
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one person who dies suddenly after living in excellent heal and (B) another who dies at He same age after living win progressive disability for many years.
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This number is then linked to life expectancy to form a single measure of population health that integrates morbidity and mortality information. Health-adjusted life expectancy is arrived at by summing the products of expected years Of life at each age multiplied by a numerical weight representing average health status at that age.
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. (Fryback notes that the actual health states that can' in principle be distinguished by different measures ranges from less than a dozen to more than 1,000.)
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Composite measures of population health are also being used In other counties to supplement traditional mortality measures and to illuminate the impact of disability. A Canadian task force, for example, has recently recommended He creation of He heath equivalent of the Gross Domestic Product to act as an overall indicator of Mends In He nation's health (Wolison, ~ 9971.
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SOURCE: Dutch Public Health Status and Forecast Report, 1997. In the international arena, comparisons of health status across countries are useful to focus attention on countries with critical needs for international assistance, to set priorities for investments in combating particular conditions and diseases, and to gain an understanding of differentials in the burden of disease among nations.
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Such measures include both the preference-based measures described above arid other ways of profiting heady such as the SF-36. Descriptive data on health status are often an important first step in identifying health problems as part of a process for improving community health, deploying resources, and overseeing the performance of those responsible in some way for individual or population health (IOM, ~ 9971.
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can be combined with a measure of life expectancy to create a single integrative measure of population health. Topics that require attention include what aspects or domains of health to measure, to what extent the component domains of a summary measure can be used in conjunction with the overall measure to provide a fuller understanding of population health, and whether and how to assign weights or values to different health states and life durations.
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The committee does not expect that any single measure will necessarily (~) fit all purposes for summary measures of population health, (2)
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. Canada is already pursuing national consensus on health data needs and measures including both highly detailed, longitudinal data on health status and health care utilization at the individual level and a family of compatible summary measures of population health (Wolfson, 1 997)
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Summary measures of population health have descnptive as well as evaluative uses at bow the individual and the population levels. As indicated earlier, the most controversial uses w~11 be those involving resource allocation decisions at the population level.
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This will help in developing advice about whether and how to use particular measures. Workshop participants suggested that for clanW' discussions of the ethical status of summary measures of population health have to distinguish between the preferences (weights assigned to different health states as determined in sample surveys)
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