Final Report on RREF 2001 - Department of Health

Part B: Development of Options for a Revised RREF
VARIABLE 2: HEALTHY YEARS OF LIFE LOST TO DISABILITY – YLD
Data Source:
Disease Study
Victorian Department of Human Services, Burden of
Issues:
• Healthy years of life lost to disability (YLD) is included as the measure of health status
that is most relevant to HACC services as it captures the burden of chronic disease on
well-being and functioning. YLD is reported as the rate at which years of healthy life
are lost to disability per 1000 population in each LGA, so that a higher YLD represents
a greater burden of disease in terms of more years of healthy life being lost to disability.
• YLD is seen to be the most appropriate of the four measures of the Burden of Disease
developed by DHS as it concentrates on the impact of chronic disease separately to
mortality whereas the other three measures of Life Expectancy (LE), Disability
Adjusted Life Years and Disability Adjusted Life Expectancy all included some
measure of mortality.
• YLD especially avoided the difficulty of interpreting the ambivalent relationship of LE
to need for HACC services that posed a problem for scaling scores. It can be argued
that areas with low LE experience higher rates of disability and hence have an increased
need for HACC services associated with premature mortality, but at the same time,
LGAs with very high LE can argue the need for more HACC services on the grounds of
having more very old people.
• The high but inverse correlations between the raw scores for LGAs for YLD and
median household income (-0.67) and with life expectancy (-0.71) show that the
variables measure related but somewhat different dimensions of well-being.
• YLD is a normally distributed variable, with 5 LGAs in the two lowest and two highest
deciles.
• The chronic conditions that contribute most to the burden of disability in YLDs are
depression, dementia, arthritis, asthma, diabetes, respiratory disease, stroke and
ischaemic heart disease, and breast cancer for women. These conditions are readily
recognised in the HACC target population.
• The development of YLDs to date has been fully reported in the Victorian Burden of
Disease Study (DHS, 2001). The proposed use of YLD in the RREF would be the first
applied use of this work in a resource allocation formula, and the measure could be
reviewed in future as the work on Burden of Disease proceeds.
<strong>Final</strong> <strong>Report</strong> July 2001 52