Measuring health burden without discriminating against the disabled

Abstract

Background Summary measures of population health, like the Disability Adjusted Life Year (DALY), are important for health policy and planning. Some worry, however, that these measures discriminate against the disabled. Methods This paper provides an analysis of the disability discrimination problem. Then, adapting a fixed-plus-variable framework proposed in welfare economics to the case of health measurement, it proposes a novel measure called the Ethically Adjusted Life Year (EALY). Results The EALY, in at least some formulations, can avoid discriminating against the disabled. It is different from, and has some advantages over, alternative ways of avoiding discrimination. Conclusions There is reason to consider using the EALY in measuring health burden and the impact of health interventions.