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Novel empirical disability weights to assess the burden of non-fatal injury

¹ Department of Social Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
² Institute of Health Policy and Management, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands
³ National Institute of Public Health and the Environment, Bilthoven, The Netherlands
⁴ Department of Public Health, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands
⁵ Consumer Safety Institute, Amsterdam, The Netherlands

J A Haagsma, National Institute of Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands; juanita.haagsma{at}rivm.nl

Background: Disability weights are necessary to estimate the disability component (years lived with disability, YLDs) of disability-adjusted life years. The original global burden of disease approach to deriving disability weights ignores temporary consequences of injury.

Objectives: To develop and apply novel empirical disability weights to improve estimates of the non-fatal burden of injury.

Methods: A set of 45 disability weights was derived for both permanent and temporary consequences of injury, using the annual profile approach. A population panel (n = 143) provided the values. The novel set of disability weights was then linked to epidemiological surveillance data on the incidence of injury in The Netherlands to calculate YLD resulting from permanent and temporary consequences of injury.

Results: The empirical disability weights for injury consequences varied from minor (corneal abrasion, 0.004) to very severe (quadriplegia, 0.719) health loss. Increasing disability weights by level of severity were found, as illustrated by concussion (0.02), versus moderate brain injury (0.193), versus severe brain injury (0.540). Application of these new disability weights showed a 36% increase in YLD as the result of unintentional injury.

Conclusions: YLD calculations based on global burden of disease disability weights underestimate the size of the injury problem by ignoring temporary health consequences. Application of novel empirical disability weights, derived using the annual profile approach, may improve calculations on the burden of non-fatal injury.