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健康产出一般很难用一个单一的效果指标进行测量。一项干预措施除了影响生存人年数以外 ,还会影响健康状况 (即生命质量 )。因此需要把对生命质量和数量的影响结合起来考虑。效用就具有这样的特点 ,主要包括质量调整生命年(QAL YS)、等价健康年 (HYES)、伤残调整生命年 (DAL Y)和伤残调整期望寿命(DALE)四个指标 ,其中质量调整生命年应用最广。但是 ,麦雷兹和甘富尼等人认为 ,QAL YS 可能与个体偏好不一致 ,建议使用 HYES这个产出指标。近近些年来世界卫生组织提倡使用后两个指标。本文概述了效用指标的测量方法及其研究进展 ,首先描述 QAL YS 的测量方法 ,其次描述 HYES 的测量方法 ,再次简单概述 DAL Y和DAL Y,最后进行总结 ,提出建议
Health outcomes are generally difficult to measure with a single effect indicator. In addition to affecting the number of years of existence, an intervention also affects the health status (ie, the quality of life). Therefore, it is necessary to consider the impact on quality of life and quantity. The utility has such characteristics, mainly including four indexes of Quality Adjusted Life Year (QAL YS), Equivalent Health Year (HYES), Disability Adjusted Life Year (DAL Y) and Disability Adjusted Life Expectancy (DALE). Adjusted life is the most widely used. However, Melez and Gaffney and others believe that QAL YS may be inconsistent with individual preferences. It is recommended to use the HYES output indicator. In recent years, the World Health Organization has advocated the use of the latter two indicators. This article outlines the measurement methods of utility indicators and their research progress. First, the measurement method of QAL YS is described. Next, the measurement method of HYES is described. Again, DAL Y and DAL Y are briefly summarized. Finally, the summary is made and suggestions are made.