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DALYs and Public Health Programs for Stroke: Australian Perspectives

  • D. A. Cadilhac
  • M. L. Moodie
  • E. E. Lalor
Reference work entry

Abstract:

 Stroke is a major cause of death and disability in many countries. In Australia, as in many other parts of the world, the incidence of stroke will increase because of the aging population. The purpose of this chapter was to describe the disease burden attributable to stroke expressed as Disability Adjusted Life Years (DALYs) in Australia; and to provide an overview of public health programs that exist to reduce this disease burden.

Methods of  DALY estimation for stroke in Australia are outlined and compared. Despite some differences in methodologies and data sources, results were consistent.

Public health programs to reduce the stroke burden include generic programs aimed at reducing common risk factors across a number of chronic diseases; and stroke specific programs to address unique aspects of stroke. Examples of these programs are provided.

A simulation analysis is presented to demonstrate the potential impact of public health programs. This analysis is based on the concept of improving access to interventions that we already know are effective in preventing stroke and/or improving stroke outcomes in a representative year (2015) using local epidemiological data. DALYs saved were calculated for the additional cases that would benefit if  current practice were improved to more closely reflect “ best-practice.” Interventions included: blood pressure lowering;  warfarin for atrial fibrillation; access to  stroke care units; increased use of  intravenous thrombolysis, cholesterol lowering and aspirin for ischemic events; and  carotid endarterectomy. In present-value (2006) terms, this would result potentially in the recovery of more than 92,000 DALYs. Thus, improving access to effective prevention and treatment interventions should produce important health gains.

Keywords

Stroke Survivor Public Health Program Stroke Incidence Disability Weight Stroke Care Unit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

ABHI

Australian Better Health Initiative

AF

atrial fibrillation

ARR

 absolute risk reduction

ASAP

Avoid Stroke as soon As Possible general practice stroke audit

AUD

Australian dollars

BoD

burden of disease

BP

blood pressure

CHD

coronary heart disease

COPD

chronic obstructive pulmonary disease

DALY

disability adjusted life year

GP

general practitioner

ICD

International Classification of Diseases

IHD

ischemic heart disease

MONICA

monitoring trends and determinants in cardiovascular disease

MORUCOS

Model Of Resource Utilization, Costs and Outcomes for Stroke

NEMESIS

North East Melbourne Stroke Incidence study

NHMRC

National Health and Medical Research Council

NSF

National Stroke Foundation (Australia)

PCSS

Perth Community Stroke study

QALY

quality adjusted life year

QOL

quality of life

SCU

stroke care unit

Southern MR

southern metropolitan region

SPARCL

Stroke Prevention by Aggressive Reduction in Cholesterol Levels

TIA

transient ischemic attack

WHO

World Health Organization

YLD

years lived with disability

YLL

years of life lost

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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • D. A. Cadilhac
  • M. L. Moodie
  • E. E. Lalor

There are no affiliations available

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