Disease-Outcome Trees, EQ-5D Scores, and Estimated Annual Losses of Quality-Adjusted Life Years (QALYs) for 14 Foodborne Pathogens in the United States

2014 ◽  
Vol 11 (5) ◽  
pp. 395-402 ◽  
Author(s):  
Michael Batz ◽  
Sandra Hoffmann ◽  
J. Glenn Morris
Keyword(s):  
United States ◽  
Foodborne Pathogens ◽  
The United States ◽  
Disease Outcome ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
Quality Adjusted Life

scholarly journals Health Impact and Cost-Effectiveness of Volume, Tiered, and Absolute Sugar Content Sugar-Sweetened Beverage Tax Policies in the United States

Circulation ◽  
2020 ◽  
Vol 142 (6) ◽  
pp. 523-534 ◽  
Author(s):  
Yujin Lee ◽  
Dariush Mozaffarian ◽  
Stephen Sy ◽  
Junxiu Liu ◽  
Parke E. Wilde ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Sugar Content ◽  
The United States ◽  
Quality Adjusted Life Years ◽  
Added Sugar ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverage ◽  
Health Gains ◽  
Life Years ◽  
Quality Adjusted Life

Background: Sugar-sweetened beverage taxes are a rapidly growing policy tool and can be based on absolute volume, sugar content tiers, or absolute sugar content. Yet, their comparative health and economic impacts have not been quantified, in particular, tiered or sugar content taxes that provide industry incentives for sugar reduction. Methods: We estimated incremental changes in diabetes mellitus and cardiovascular disease, quality-adjusted life-years, costs, and cost-effectiveness of 3 sugar-sweetened beverage tax designs in the United States, on the basis of (1) volume ($0.01/oz), (2) tiers (<5 g of added sugar/8 oz: no tax; 5–20 g/8 oz: $0.01/oz; and >20 g/8 oz: $0.02/oz), and (3) absolute sugar content ($0.01 per teaspoon added sugar), each compared with a base case of modest ongoing voluntary industry reformulation. A validated microsimulation model, CVD-PREDICT (Cardiovascular Disease Policy Model for Risk, Events, Detection, Interventions, Costs, and Trends), incorporated national demographic and dietary data from the National Health and Nutrition Examination Survey, policy effects and sugar-sweetened beverage-related diseases from meta-analyses, and industry reformulation and health-related costs from established sources. Results: Over a lifetime, the volume, tiered, and absolute sugar content taxes would generate $80.4 billion, $142 billion, and $41.7 billion in tax revenue, respectively. From a healthcare perspective, the volume tax would prevent 850 000 cardiovascular disease (95% CI, 836 000–864 000) and 269 000 diabetes mellitus (265 000–274 000) cases, gain 2.44 million quality-adjusted life-years (2.40–2.48), and save $53.2 billion net costs (52.3–54.1). Health gains and savings were approximately doubled for the tiered and absolute sugar content taxes. Results were robust for societal and government perspectives, at 10 years follow-up, and with lower (50%) tax pass-through. Health gains were largest in young adults, blacks and Hispanics, and lower-income Americans. Conclusions: All sugar-sweetened beverage tax designs would generate substantial health gains and savings. Tiered and absolute sugar content taxes should be considered and evaluated for maximal potential gains.

An assessment of the human health impact of seven leading foodborne pathogens in the United States using disability adjusted life years

2015 ◽  
Vol 143 (13) ◽  
pp. 2795-2804 ◽  
Author(s):  
E. SCALLAN ◽  
R. M. HOEKSTRA ◽  
B. E. MAHON ◽  
T. F. JONES ◽  
P. M. GRIFFIN
Keyword(s):  
United States ◽  
Foodborne Pathogens ◽  
Health Impact ◽  
The United States ◽  
Health State ◽  
Foodborne Disease ◽  
Health States ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Safety Interventions

SUMMARYWe explored the overall impact of foodborne disease caused by seven leading foodborne pathogens in the United States using the disability adjusted life year (DALY). We defined health states for each pathogen (acute illness and sequelae) and estimated the average annual incidence of each health state using data from public health surveillance and previously published estimates from studies in the United States, Canada and Europe. These pathogens caused about 112 000 DALYs annually due to foodborne illnesses acquired in the United States. Non-typhoidal Salmonella (32 900) and Toxoplasma (32 700) caused the most DALYs, followed by Campylobacter (22 500), norovirus (9900), Listeria monocytogenes (8800), Clostridium perfringens (4000), and Escherichia coli O157 (1200). These estimates can be used to prioritize food safety interventions. Future estimates of the burden of foodborne disease in DALYs would be improved by addressing important data gaps and by the development and validation of US-specific disability weights for foodborne diseases.

Annual Cost of Illness and Quality-Adjusted Life Year Losses in the United States Due to 14 Foodborne Pathogens†

2012 ◽  
Vol 75 (7) ◽  
pp. 1292-1302 ◽  
Author(s):  
SANDRA HOFFMANN ◽  
MICHAEL B. BATZ ◽  
J. GLENN MORRIS
Keyword(s):  
United States ◽  
Cost Of Illness ◽  
Foodborne Pathogens ◽  
Annual Cost ◽  
The United States ◽  
Quality Adjusted Life Year ◽  
Companion Article ◽  
Qaly Loss ◽  
Euroqol 5D ◽  
Quality Adjusted Life

In this article we estimate the annual cost of illness and quality-adjusted life year (QALY) loss in the United States caused by 14 of the 31 major foodborne pathogens reported on by Scallan et al. (Emerg. Infect. Dis. 17:7–15, 2011), based on their incidence estimates of foodborne illness in the United States. These 14 pathogens account for 95% of illnesses and hospitalizations and 98% of deaths due to identifiable pathogens estimated by Scallan et al. We estimate that these 14 pathogens cause $14.0 billion (ranging from $4.4 billion to $33.0 billion) in cost of illness and a loss of 61,000 QALYs (ranging from 19,000 to 145,000 QALYs) per year. Roughly 90% of this loss is caused by five pathogens: nontyphoidal Salmonella enterica ($3.3 billion; 17,000 QALYs), Campylobacter spp. ($1.7 billion; 13,300 QALYs), Listeria monocytogenes ($2.6 billion; 9,400 QALYs), Toxoplasma gondii ($3 billion; 11,000 QALYs), and norovirus ($2 billion; 5,000 QALYs). A companion article attributes losses estimated in this study to the consumption of specific categories of foods. To arrive at these estimates, for each pathogen we create disease outcome trees that characterize the symptoms, severities, durations, outcomes, and likelihoods of health states associated with that pathogen. We then estimate the cost of illness (medical costs, productivity loss, and valuation of premature mortality) for each pathogen. We also estimate QALY loss for each health state associated with a given pathogen, using the EuroQol 5D scale. Construction of disease outcome trees, outcome-specific cost of illness, and EuroQol 5D scoring are described in greater detail in a second companion article.

Identifying Public Health Problems

2018 ◽  
Author(s):  
Scott Burris ◽  
Micah L. Berman ◽  
Matthew Penn, and ◽  
Tara Ramanathan Holiday
Keyword(s):  
Public Health ◽  
Health Problems ◽  
Health Priorities ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Study Designs ◽  
Quality Adjusted Life

Chapter 5 discusses the use of epidemiology to identify the source of public health problems and inform policymaking. It uses a case study to illustrate how researchers, policymakers, and practitioners detect diseases, identify their sources, determine the extent of an outbreak, and prevent new infections. The chapter also defines key measures in epidemiology that can indicate public health priorities, including morbidity and mortality, years of potential life lost, and measures of lifetime impacts, including disability-adjusted life years and quality-adjusted life years. Finally, the chapter reviews epidemiological study designs, differentiating between experimental and observational studies, to show how to interpret data and identify limitations.

Medicare’s Hospital Value-Based Purchasing Program Values Quality over QALYs

2021 ◽  
pp. 0272989X2110171
Author(s):  
Edward C. Norton ◽  
Jun Li ◽  
Anup Das ◽  
Andrew M. Ryan ◽  
Lena M. Chen
Keyword(s):  
Quality Of Care ◽  
Pay For Performance ◽  
Health Interventions ◽  
Quality Adjusted Life Years ◽  
Value Based Purchasing ◽  
Quality Performance ◽  
Life Years ◽  
Policy Adjustments ◽  
Quality Adjusted Life

Medicare’s Hospital Value-Based Purchasing Program (HVBP) is the first national pay-for-performance program to combine measures of quality of care with a measure of episode spending. We estimated the implicit tradeoffs between mortality reduction and spending reduction. To earn points in HVBP, a hospital can either lower mortality or reduce spending, creating a tradeoff between the 2 measures. We analyzed the quality performance and earned points of 2814 hospitals using publicly available data. We then quantified the tradeoffs between spending and mortality in terms of quality-adjusted life-years (QALYs). If incentives in the program were balanced, then the tradeoff between spending and QALYs should be comparable with those of high-value health interventions, roughly $50,000 to $200,000 per QALY. Instead, the tradeoff in HVBP was about $1.2 million per QALY. HVBP overvalues improvements in quality of care relative to spending reductions. We propose 2 possible policy adjustments that could improve incentives for hospitals to deliver high-value care.

Good, Fairness and QALYs

1988 ◽  
Vol 23 ◽  
pp. 57-73 ◽  
Author(s):  
John Broome
Keyword(s):  
Health Service ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
Quality Adjusted Life

Counting QALYs (quality adjusted life years) has been proposed as a way of deciding how resources should be distributed in the health service: put resources where they will produce the most QALYs. This proposal has encountered strong opposition. There has been a disagreement between some economists favouring QALYs and some philosophers opposing them. But the argument has, I think, mostly been at cross-purposes. Those in favour of QALYs point out what they can do, and those against point out what they can't. There need be no disagreement about this. What is needed is to sort out what is the proper domain of QALYs, and it may be possible to do this amicably. Then we may be able to get on with the more useful job of deciding how well QALYs perform within their domain. In this paper I shall try to accomplish the first task (sections II–IV), and make a start on the second (sections V–VIII).

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