Saturday, June 22, 2024

Multistate Models as an Alternative to Sullivan Method for Health Expectancies

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In response to the growing necessity of incorporating quality of life indicators into health planning, a recent study evaluates the effectiveness of using multistate models over the traditional Sullivan method. This approach leverages morbidity and mortality datasets to estimate health expectancies, providing a potentially more accurate and efficient means of monitoring population health in the context of aging demographics and healthcare system stressors.

Study Overview

The research utilized data from the county of Baix Empordà (Catalonia) for the years 2016 and 2017, encompassing a population of 91,130 individuals. The study classified anonymized individual information—such as diagnoses, procedures, and pharmacy consumption—into distinct health states using ICD and ATC codes. Through observed health transitions and mortality rates, life expectancies by health state were derived from a multistate microsimulation model.

Key findings revealed that healthy life expectancies at birth and age 65 for females and males were significantly lower when calculated using this multistate model compared to the Sullivan method. Specifically, the healthy life expectancy at age 65 for females was 2.43 years and for males, 2.17 years, showing a discrepancy of 8.25 and 9.26 years respectively when compared to Sullivan equivalents.

Consistent Life Expectancy Results

Despite the differences in healthy life expectancies, the study found that overall life expectancy figures were consistent with standard government reports. For instance, life expectancy at birth for females was 85.82 years and for males, 80.58 years. At age 65, females had a life expectancy of 22.31 years, while males had 18.86 years.

The findings suggest that health indicators can be efficiently obtained from mortality and morbidity data through multistate models, bypassing the need for health surveys. This alternative method offers a data-driven approach that could enhance health planning and monitoring efforts, particularly in the face of an aging population.

Key Insights for Health Planning

– Multistate models utilize existing morbidity and mortality data, potentially reducing the need for extensive health surveys.
– Healthy life expectancies derived from multistate models are consistently lower than those from the Sullivan method due to differing health concepts (data-based vs. self-perception).
– Life expectancy results from multistate models align with standard government reports, indicating the reliability of this method.

The study’s results underscore the importance of considering alternative methods for health expectancy estimation, particularly in health planning contexts. By employing multistate models, policymakers can obtain more accurate health indicators that reflect true population health states, thereby improving resource allocation and strategic planning.

Original Article: PLoS One. 2024 May 21;19(5):e0302174. doi: 10.1371/journal.pone.0302174. eCollection 2024.

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