Comparing data sources in estimating disability-adjusted life years (DALYs) for ischemic heart disease and chronic obstructive pulmonary disease in a cross-sectional setting in Finland

Laura Paalanen; Jaakko Reinikainen; Tommi Härkänen; Tiina Mattila; Tiina Laatikainen; Pekka Jousilahti; Hanna Tolonen

doi:10.1186/s13690-020-00439-6

Comparing data sources in estimating disability-adjusted life years (DALYs) for ischemic heart disease and chronic obstructive pulmonary disease in a cross-sectional setting in Finland

Arch Public Health. 2020 Jun 18:78:58. doi: 10.1186/s13690-020-00439-6. eCollection 2020.

Authors

Laura Paalanen¹, Jaakko Reinikainen¹, Tommi Härkänen¹, Tiina Mattila^{1

2

3}, Tiina Laatikainen^{1

4

5}, Pekka Jousilahti¹, Hanna Tolonen¹

Affiliations

¹ Department of Public Health Solutions, Finnish Institute for Health and Welfare (THL), P.O. Box 30, FI-00271 Helsinki, Finland.
² Department of Pulmonary Diseases, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
³ Faculty of Medicine, University of Helsinki, Helsinki, Finland.
⁴ Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
⁵ Joint Municipal Authority for North Karelia Social and Health Services (Siun sote), Joensuu, Finland.

Abstract

Background: The disability-adjusted life years (DALYs) summarize the burden of years of life lost (YLL) due to premature mortality and years lost due to disability (YLD). Our aim was to estimate the burden of ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) in Finland in 2012, and to examine, how much the YLD are affected by the use of different data sources.

Methods: The YLL were calculated using mortality data for the Finnish 25-74-year-old population in 2012. The YLD were calculated using data from the FINRISK 2012 survey (3041 males, 3383 females aged 25-74 years) and then directly adjusted to the corresponding population. Different administrative registers on 1) hospital inpatient episodes and specialist outpatient visits, 2) entitlement to specially reimbursed medicines, and 3) purchases of prescribed medicines were used for estimation of the YLD in addition to self-reported data. The DALYs were calculated without age-weighting.

Results: The YLL for IHD were 37.5 for males and 9.1 for females per 1000 population among 25-74-year-old people in Finland in 2012. The YLD for IHD varied markedly depending on which data sources were used. All data sources combined, the YLD per 1000 were 5.3 for males and 2.5 for females resulting in estimated 42.8 and 11.6 DALYs per 1000 due to IHD among males and females, respectively. For COPD, the YLL were 4.7 for males and 2.0 for females per 1000. Also for COPD, the YLD varied markedly depending on data sources used. The YLD per 1000 based on all data sources combined were 2.0 for males and 1.6 for females. As a result, estimated 6.7 and 3.6 DALYs per 1000 were due to COPD among males and females, respectively.

Conclusions: Especially for COPD, all mild disease cases could probably not be identified from the included registers. Thereby, including survey data improved the coverage of the data. The YLD of IHD and COPD varied markedly between the data sources used in the calculations. However, as YLL constituted a major part of DALYs for these diseases, the variation in YLD did not lead to substantial variation in DALYs.

Keywords: Chronic obstructive pulmonary disease; Disability-adjusted life year; Disease burden; Health examination survey; Ischemic heart disease; Register data; Self-report.