Using disability adjusted life years to value the treatment of thirty chronic conditions in the U.S. from 1987 to 2010: a proof of concept
Health care spending in the U.S. grew two trillion dollars from 1987 to 2010, a 400% increase, but our understanding of the value of that increase is limited. In this paper we estimate the net value of spending for thirty chronic diseases between 1987 and 2010 by assigning a monetary value to changes in health outcomes and relating it to the costs of treating each disease. Changes in health outcomes are measured using a newly-available time series of disability adjusted life years (DALYs) data from the Institute for Health Metrics and Evaluation. Spending on treatments are determined using health care expenditure data from nationally representative surveys. We find the net value of treatment has grown substantially for several diseases. Overall, 20 of the 30 chronic conditions studied experienced an increase in health outcomes over the period, with 8 of those 20 showing a decrease in per-patient spending. Our estimates of net value of health spending using DALYs data are simple to apply and results are generally consistent with previous estimates which usually involve onerous data collection methods to study a single disease. The DALYs data have potential to be a useful, low-cost way to measure changes in health outcomes. However, challenges remain in using DALYs data to accurately measure the changing value of health care spending on the treatment of disease.
KeywordsHealth care spending Disability adjusted life years Treatment value Chronic conditions
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest, ethics issues, or funding to report.
The views expressed in this paper are solely those of the authors and not necessarily those of the U.S. Bureau of Economic Analysis or the U.S. Department of Commerce.
- Aizcorbe, A., Bradley, R., Greenaway-McGrevy, R., Herauf, B., Kane, R., Liebman, E., Pack, S., & Rozental, L. (2011). Alternative price indexes for medical care: Evidence from the MEPS survey. U.S. Bureau of Economic Analysis working paper WP2011-01, Washington, DC.Google Scholar
- Aizcorbe, A., Liebman, E., Cutler, D. M., & Rosen, A. B. (2012). Household consumption expenditures for medical care: An alternate presentation. Survey of Current Business, 92(6), 34–48.Google Scholar
- Centers for Medicare and Medicaid Services. (2017). National health care spending in 2016. Office of the Actuary, National Health Statistics Group. Retrieved October 24, 2018, from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html.
- Hall, A. E., & Highfill, T. (2013). Calculating disease-based medical care expenditure indexes for medicare beneficiaries: A comparison of method and data choices. National Bureau of Economic Research working paper no. 19720, Cambridge, MA.Google Scholar
- Institute for Health Metrics and Evaluation. (2010). The global burden of disease. University of Washington.Google Scholar
- Medical Expenditure Panel Survey. (2010). Agency for healthcare research and quality. Household full year file, 2010. [Internet]. Rockville, MD: AHRQ.Google Scholar
- National Medical Expenditure Survey. (1987). Household survey, health status questionnaire, and access to care supplement [public use tape 9] (ICPSR 9674) [Internet]. Ann Arbor, MI: University of Michigan Institute for Social Research.Google Scholar
- Organisation for Economic Co-operation and Development, Statistics Directorate. (2010). Towards measuring the volume output of education and health services: A handbook. Working paper number 31.Google Scholar
- Rosen, A. B., Aizcorbe, A., Highfill, T., Chernew, M. E., Liebman, E., Ghosh, K., et al. (2018). Attribution of health care costs to diseases. Measuring and Modeling Health Care Costs, 76, 173.Google Scholar
- Siegel, R., Naishadham, D., & Jemal, A. (2012). Cancer statistics, 2012. CA: A Cancer Journal for Clinicians, 62(1), 10–29.Google Scholar
- World Health Organization. (2001). National burden of disease studies: A practical guide. Global program on evidence for health policy. WHO, Geneva. Edition 2.0, October 2001.Google Scholar