Quantifying burden of disease to support public health policy in Belgium: opportunities and constraints

BMC Public Health

Niko Speybroeck²  Herman Van Oyen⁴  Claudia Stein¹  Pierre Dorny³  Luc Duchateau⁵  G Suzanne A Smit⁶  Charline Maertens de Noordhout²  Brecht Devleesschauwer⁶ 

[1] Division of Information, Evidence, Research, and Innovation, World Health Organization Regional Office for Europe, Copenhagen, Denmark;Institute of Health and Society (IRSS), Faculty of Public Health, Université catholique de Louvain, Brussels, Belgium;Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium;Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium;Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium

关键词: Health policy;    Disability-adjusted life years;    Disease burden;    Belgium;   

Others  :  1122922
DOI  :  10.1186/1471-2458-14-1196

 received in 2014-05-06, accepted in 2014-10-24,  发布年份 2014

【 摘 要 】

Background

To support public health policy, information on the burden of disease is essential. In recent years, the Disability-Adjusted Life Year (DALY) has emerged as the most important summary measure of public health. DALYs quantify the number of healthy life years lost due to morbidity and mortality, and thereby facilitate the comparison of the relative impact of diseases and risk factors and the monitoring of public health over time.

Discussion

Evidence on the disease burden in Belgium, expressed as DALYs, is available from international and national efforts. Non-communicable diseases and injuries dominate the overall disease burden, while dietary risks, tobacco smoking, and high body-mass index are the major risk factors for ill health. Notwithstanding these efforts, if DALYs were to be used for guiding health policy, a more systematic approach is required. By integrating DALYs in the current data generating systems, comparable estimates, rooted in recent local data, can be produced. This might however be hampered by several restrictions, such as limited harmonization, timeliness, inclusiveness and accessibility of current databases.

Summary

Routine quantification of disease burden in terms of DALYs would provide a significant added value to evidence-based public health policy in Belgium, although some hurdles need to be cleared.

【 授权许可】

   
2014 Devleesschauwer et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Murray CJ, Ezzati M, Flaxman AD, Lim S, Lozano R, Michaud C, Naghavi M, Salomon JA, Shibuya K, Vos T, Wikler D, Lopez AD: GBD 2010: design, definitions, and metrics. Lancet 2012, 380:2063-2066.
• [2]Tan-Torres Edejer T, Baltussen R, Adam T, Hutubessy R, Acharya A, Evans D, Murray CJL: Making Choices in Health: WHO Guide to Cost-Effectiveness Analysis. Geneva: WHO Press; 2003.
• [3]Marshall SJ: Developing countries face double burden of disease. Bull World Health Organ 2004, 82:556.
• [4]Jelenc M, Van HE, Albreht T, Meglic M, Seljak M, Krnel SR: Joint action European partnership for action against cancer. Arch Public Health 2012, 70:24. BioMed Central Full Text
• [5]Bryant LL, Corbett KK, Kutner JS: In their own words: a model of healthy aging. Soc Sci Med 2001, 53:927-941.
• [6]Robine JM, Cambois E, Nusselder W, Jeune B, Oyen HV, Jagger C: The joint action on healthy life years (JA: EHLEIS). Arch Public Health 2013, 71:2. BioMed Central Full Text
• [7]Murray CJ, Salomon JA, Mathers C: A critical examination of summary measures of population health. Bull World Health Organ 2000, 78:981-994.
• [8]Murray C, Lopez A: The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Cambridge: Harvard University Press; 1996.
• [9]Lopez A, Mathers C, Ezzati M, Jamison D, Murray C: Global Burden of Disease and Risk Factors. New York: Oxford University Press; 2006.
• [10]World Health Organization: The Global Burden of Disease: 2004 Update. Geneva: WHO Press; 2008.
• [11]Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, Aboyans V, Abraham J, Ackerman I, Aggarwal R, Ahn SY, Ali MK, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Bahalim AN, Barker-Collo S, Barrero LH, Bartels DH, Basáñez MG, Baxter A, Bell ML, Benjamin EJ, et al.: Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet 2012, 380:2197-2223.
• [12]World Health Organization: WHO methods and data sources for global burden of disease estimates 2000–2011. [http://www.who.int/entity/healthinfo/statistics/GlobalDALYmethods_2000_2011.pdf webcite]
• [13]The World Bank: World Development Report 1993: Investing in Health. New York: Oxford University Press; 1993.
• [14]Murray CJ: Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull World Health Organ 1994, 72:429-445.
• [15]Murray CJ, Acharya AK: Understanding DALYs (disability-adjusted life years). J Health Econ 1997, 16:703-730.
• [16]Devleesschauwer B, Havelaar AH, Maertens de Noordhout C, Haagsma JA, Praet N, Dorny P, Duchateau L, Torgerson PR, Van Oyen H, Speybroeck N: Calculating disability-adjusted life years to quantify burden of disease. Int J Public Health 2014, 59:565-569.
• [17]Barendregt JJ, Bonneux L, Van der Maas PJ: DALYs: the age-weights on balance. Bull World Health Organ 1996, 74:439-443.
• [18]Arnesen T, Kapiriri L: Can the value choices in DALYs influence global priority-setting? Health Policy 2004, 70:137-149.
• [19]Devleesschauwer B, Havelaar AH, Maertens de Noordhout C, Haagsma JA, Praet N, Dorny P, Duchateau L, Torgerson PR, Van Oyen H, Speybroeck N: DALY calculation in practice: a stepwise approach. Int J Public Health 2014, 59:571-574.
• [20]Muyldermans G, Litzroth A, Ducoffre G, Quoilin S: Establishment and reinforcement of the national reference centers for human microbiology in Belgium. Arch Public Health 2012, 70:16. BioMed Central Full Text
• [21]Boffin N, Bossuyt N, Vanthomme K, Van Casteren V: Readiness of the Belgian network of sentinel general practitioners to deliver electronic health record data for surveillance purposes: results of survey study. BMC Fam Pract 2010, 11:50. BioMed Central Full Text
• [22]Commission for the protection of privacy, Royal Decree 2001, Belgium [http://www.privacycommission.be/sites/privacycommission/files/documents/Royal_Decree_2001.pdf webcite]
• [23]Bilcke J, Van DP, De SF, Hanquet G, Van RM, Beutels P: The health and economic burden of rotavirus disease in Belgium. Eur J Pediatr 2008, 167:1409-1419.
• [24]D’Havé A: Aankondiging omschakeling van ICD-9-CM naar ICD-10-BE vanaf 1 januari 2015 (Announcement conversion of ICD-9-CM to ICD-10-BE from January 1, 2015). Brussels: FPS Health, Food chain safety and Environment; 2011.
• [25]Vanthomme K, Walckiers D, Van OH: Belgian health-related data in three international databases. Arch Public Health 2011, 69:6. BioMed Central Full Text
• [26]Kuchenmüller T, Hird S, Stein C, Kramarz P, Nanda A, Havelaar AH: Estimating the global burden of foodborne diseases–a collaborative effort. Euro Surveill 2009, 14:19195.
• [27]Institute for Health Metrics and Evaluation (IHME): Global Burden of Disease Study 2010. Belgium Global Burden of Disease Study 2010 (GBD 2010) Results 1990–2010. [http://ghdx.healthdata.org/record/belgium-global-burden-disease-study-2010-gbd-2010-results-1990-2010 webcite]
• [28]Institute for Health Metrics and Evaluation (IHME): GBD Profile: Belgium. [http://www.healthdata.org/sites/default/files/files/country_profiles/GBD/ihme_gbd_country_report_belgium.pdf webcite]
• [29]Institute for Health Metrics and Evaluation (IHME): The Global Burden of Disease: Generating Evidence, Guiding Policy – European Union and European Free Trade Association Regional Edition. Seattle, WA: Institute for Health Metrics and Evaluation; 2013.
• [30]Kretzschmar M, Mangen MJ, Pinheiro P, Jahn B, Fevre EM, Longhi S, Lai T, Havelaar AH, Stein C, Cassini A, Kramarz P, BCoDE consortium: New methodology for estimating the burden of infectious diseases in Europe. PLoS Med 2012, 9:e1001205.
• [31]van Lier EA, Havelaar AH: Disease burden of infectious diseases in Europe: a pilot study. [http://www.rivm.nl/bibliotheek/rapporten/215011001.pdf webcite]
• [32]Baert E, Van Oyen H, Aelvoet W, De Henauw S, De Backer G: DALY (disability adjusted life years): een conceptueel model van geïntegreerde gezondheidsindicator op basis van verloren levensjaren door voortijdige sterfte en ziekte (DALY (disability adjusted life years): a conceptual model of integrated health indicator based on years of life lost due to premature death and disease). In Gezondheidsindicatoren 1998. Brussels: Flemish Agency for Care and Health; 2000.
• [33]Baert E, De Backer G, Byttebier G, De Henauw S, Van Oyen H, Aelvoet W: Disability Adjusted Life Years. Een eerste berekening voor Vlaanderen (Disability Adjusted Life Years. A first calculation for Flanders). In Gezondheidsindicatoren 2000. Brussels: Flemish Agency for Care and Health; 2002.
• [34]Melse JM, Essink-Bot ML, Kramers PG, Hoeymans N: A national burden of disease calculation: Dutch disability-adjusted life-years. Am J Public Health 2000, 90:1241-1247.
• [35]Buekers J, Torfs R, Deutsch F, Lefebvre W, Bossuyt M: Inschatting ziektelast en externe kosten veroorzaakt door verschillende milieufactoren in Vlaanderen (Assessment of Disease Burden and External Costs Caused by Various Environmental Factors in Flanders). Mechelen: Flemish Environment Agency (VMM); 2012.
• [36]Stassen KR, Collier P, Torfs R: Environmental burden of disease due to transportation noise in Flanders (Belgium). Transport Res D Transport Environ 2008, 13:355-358.
• [37]Dhondt S, Macharis C, Terryn N, Van MF, Putman K: Health burden of road traffic accidents, an analysis of clinical data on disability and mortality exposure rates in Flanders and Brussels. Accid Anal Prev 2013, 50:659-666.
• [38]Henrard S, Devleesschauwer B, Beutels P, Callens M, De Smet F, Hermans C, Speybroeck N: The health and economic burden of haemophilia in Belgium: a rare, expensive and challenging disease. Orphanet J Rare Dis 2014, 9:39. BioMed Central Full Text
• [39]Ikram UZ, Kunst AE, Lamkaddem M, Stronks K: The disease burden across different ethnic groups in Amsterdam, the Netherlands, 2011–2030. Eur J Public Health 2014, 24:600-605.
• [40]Gilmour S, Liao Y, Bilano V, Shibuya K: Burden of disease in Japan: using national and subnational data to inform local health policy. J Prev Med Public Health 2014, 47:136-143.
• [41]Mathers CD, Vos ET, Stevenson CE, Begg SJ: The burden of disease and injury in Australia. Bull World Health Organ 2001, 79:1076-1084.