Geographical variation in quality-adjusted life expectancy in the North Denmark Region

Area of Science:

• Public Health
• Health Economics
• Biostatistics

Background:

• Quality-Adjusted Life Expectancy (QALE) is a key metric for assessing population health.
• Understanding geographical variations in QALE is crucial for targeted health interventions.
• Previous studies have highlighted the importance of both mortality and health-related quality of life (HRQoL) in determining QALE.

Purpose of the Study:

• To examine geographical variations in QALE across municipalities in the North Denmark Region.
• To decompose QALE into its mortality and HRQoL components to identify drivers of variation.
• To inform future health policy development based on regional health expectancy differences.

Main Methods:

• Utilized EQ-5D-5L questionnaire data from 19,598 respondents for HRQoL measures.
• Constructed abridged periodic life tables using mortality data stratified by age, sex, and municipality.
• Applied the Andreev et al. stepwise replacement algorithm to decompose QALE and analyze variation drivers.

Main Results:

• Regional average QALE at age 16 was 52.6 QALYs for men and 53.1 QALYs for women.
• No statistically significant differences in QALE were found between municipalities.
• The highest QALE variations were observed between Rebild and Hjørring for males (2.57 QALE) and Rebild and Vesthimmerland for females (3.03 QALE), driven by HRQoL and mortality.

Conclusions:

• While not statistically significant, geographical variations in QALE exist within the North Denmark Region.
• HRQoL and mortality rates are key determinants of these observed QALE differences.
• Further research is recommended to explore the underlying reasons for these variations and guide policy.