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TABLE 4.4 Example of an Individual Scheme of Trade-off Values

 

Trade-Off Values

Morbidity Category

Description

Unit

Under 5 Years

5–14 Years

15–59 Years

60 Years and Over

A

Moderate localized pain and/or mild systemic reaction, or impairment requiring minor change in normal activities, and associated with some restriction of work activity

Days

20,000

15,000

10,000

5,000

B

Moderate pain and/or moderate impairment requiring moderate change in normal activities, e.g., housebound or in bed, and associated with temporary loss of ability to work

Days

10,000

10,000

5,000

500

C

Severe pain, severe short-term impairment, or hospitalization

Days

1,000

500

200

100

D

Mild chronic disability (not requiring hospitalization, institutionalization, or other major limitation of normal activity, and resulting in minor limitation of ability to work)

Cases

100

100

200

200

E

Moderate to severe chronic disability (requiring hospitalization, special care, or other major limitation of normal activity, and seriously restricting ability to work)

Cases

5

5

10

2

F

Total impairment

Cases

1

1

1

2

G

Reproductive impairment resulting in infertility

Cases

5

5

2

100

H

Death

Cases

1

1

1

1

 

Deaths adjusted for age group

1

0.5

0.3

3

The total score or total disease burden value (TDBV) is then a summation of the subtotals. A sample calculation sheet is shown in Table 4.6.

The views of various individuals on the relative importance of diseases can be compared by ranking diseases based on their TDBVs or by normalizing values so that the highest value represents some arbitrary common number, such as 100.

Prior to presenting the results of the disease burden comparison performed by this committee, some discussion of the method is desirable.



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