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Evidence-based Public HealthEffectiveness and efficiency$
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Amanda Killoran and Mike P. Kelly

Print publication date: 2009

Print ISBN-13: 9780199563623

Published to Oxford Scholarship Online: February 2010

DOI: 10.1093/acprof:oso/9780199563623.001.0001

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Measuring overall population health: the use and abuse of QALYs

Measuring overall population health: the use and abuse of QALYs

(p.148) Chapter 10 Measuring overall population health: the use and abuse of QALYs
Evidence-based Public Health

Richard Cookson

Anthony Culyer

Oxford University Press

This chapter begins by explaining how Quality Adjusted Life Year (QALY) is produced, setting out the basic arithmetic of the QALY, and then describing how QALYs incorporate evidence on health-related quality of life from surveys of patients and the general public. It then turns to potential uses and abuses of the QALY. The final section discusses future research directions, focusing in particular on how one might try to value QALYs vis-à-vis the many non-health outcomes that are often important in public health. The main aim of the chapter is to provide a clear introduction to the QALY with an emphasis on practical application to public health. A secondary aim is to assuage, if not dispel, some of the methodological and ethical concerns that can arise in relation to the QALY. The QALY is simply a tool. Few tools are fit for all purposes, just as few horses are fit for all courses. The emphasis ought, as always, to be on sensible application and interpretation, based on a full appreciation of the pros and cons.

Keywords:   population health, public health, health outcomes

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