The Disability-Adjusted Life Year (DALY) and Influenza in Ireland An evaluation of the suitability of the DALY as a metric for measuring and managing the burden of influenza in Ireland

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Quigley, Roisin
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The burden of influenza in Ireland is insufficiently characterised. Quantifying the burden of influenza could lead to benefits such as informed decision-making on policy, effective healthcare planning and preparation and prioritisation of health research investments and healthcare interventions. These benefits are particularly pertinent in today’s Irish setting, as it is facing chronic resource shortages. The Disability Adjusted Life Year (DALY) is proposed as a useful metric for quantifying the burden of influenza. It is a measure of overall reduction in health due to disability before death and the decline in life expectancy due to death. This research aimed to use this metric to estimate the burden of influenza in Ireland and to investigate the feasibility, suitability, utility and validity of the estimate in practice in the Irish healthcare and health policy setting. A mixed-method approach with an overall interpretivist philosophy was employed. Using a quantitative method, the DALY calculation was performed to estimate the burden of influenza in Ireland in DALYs and to explore variability of the calculation. A qualitative method was then used to gain the views of subject matter experts on the validity, feasibility, suitability and utility of the DALY to them in practice. Both methods were combined via abduction to arrive at a conclusion. Results showed that per 100,000 population, influenza contributed 87.75 DALYs in the 2018/2019 season and 38.8 DALYs in the 2017/2018 season. The utility of this estimate depends upon the DALY’sfunction as a ”common currency” for comparison. It would be suitable and useful to inform HSE policy and highlight the burden of influenza; however, few other appropriate DALY estimates exist for comparison. Therefore, the estimate cannot be used to arrive at a conclusion regarding the burden of influenza and it is not yet feasible to be used for its intended purpose. This estimate will provide a useful comparator to future studies. The wider adoption of the DALY in Ireland is required for its utility to be realised and benefits gained.
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