Age weighting and discounting (cont.)
The following figure compares the YLL that result from a death at each age if one does not discount, which you have seen already, with the equivalent loss of YLL if they are discounted at 3 per cent.
From the figure, estimate the undiscounted and discounted years of life lost to deaths at age 20 and age 80. How do they compare?
| Basis for calculation | Death at 20 (1) | Death at 80 (2) | Ratio (1)/(2) |
|---|---|---|---|
| Undiscounted | 66.4 | 11.0 | 6.0 |
| Discounted | 28.8 | 9.4 | 3.1 |
A death at age 20 results in about 3 times more DALYs as a death at age 80 if its impact is discounted, but in about 6 times more DALYs if it is not.
Note that, if one discounts at a rate of 3 per cent, the health impact of a death at any point in the first 20 years of life is almost identical. Because mortality in the reference life table is so low, however, the undiscounted loss resulting from an infant death is almost 20 years greater than the loss resulting from the death of someone 20 years older.
Deciding not to discount in the 2010 GBD study also increased the estimated burden of disease resulting from disease episodes at young ages that lead to long-term or lifelong disability. The impact on the prevalence based estimates of YLD, however, is smaller than it would have been on an incidence based measure of YLD.
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Well done. A death at age 20 results in about 3 times more DALYs as a death at age 80 if its impact is discounted, but in about 6 times more DALYs if it is not.
Note that, if one discounts at a rate of 3 per cent, the health impact of a death at any point in the first 20 years of life is almost identical. Because mortality in the reference life table is so low, however, the undiscounted loss resulting from an infant death is almost 20 years greater than the loss resulting from the death of someone 20 years older.
Deciding not to discount in the 2010 GBD study also increased the estimated burden of disease resulting from disease episodes at young ages that lead to long-term or lifelong disability. The impact on the prevalence based estimates of YLD, however, is smaller than it would have been on an incidence based measure of YLD.
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