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

  • Tina HighfillEmail author
  • Elizabeth Bernstein
Research Article


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.


Health 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.


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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2019

Authors and Affiliations

  1. 1.Department of CommerceUS Bureau of Economic AnalysisSuitlandUSA

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