Study objective-Despite excellent mortality indicators, there is clear evidence that the health status of the population of Geneva could be improved if more attention and resources were devoted to prevention strategies. To identify a set of robust health priorities an original approach was used triangulating results between three methods. Methods-The study calculated potential years of life lost, disability adjusted years of life lost, and conducted a Delphi survey to gather the opinion of health professionals and the general public. Main results-Several health conditions were unanimously selected by all three methods as top priorities: cardiovascular diseases, AIDS, respiratory cancer, breast cancer for women, suicide and traYc accidents. In addition, two determinants-alcohol abuse and tobacco abuse-for which a clear conceptual link could be established between all methods were chosen. Connections between priorities identified through the DALY and the Delphi method lead to further inclusion of chronic back pain and depression. Some issues solely identified through the Delphi survey were included as they were consistently considered important by professionals and the lay public alike-violence in the family, unemployment, social exclusion. Conclusions-These results indicate that health priorities, and by extension health care priorities, would benefit from using a mix of quantitative and qualitative research methods. The triangulation of results allows for a broader perspective and makes results more acceptable.
OBJETIVO: Calculou-se a carga de doença devida à mortalidade, os anos de vida perdidos por "morte prematura" (AVP), nos Estados do Rio Grande do Sul e Santa Catarina, comparando alguns resultados com o Brasil. MÉTODOS: Baseou-se nos anos de vida ajustados em função da incapacidade (AVAI), indicador que agrega mortalidade e morbidade em uma medida global. As populações de estudo foram os óbitos de residentes nos Estados em 1994 e no Brasil em 1993. RESULTADOS: Embora a maior carga por mortalidade seja imposta por causas ligadas a um estágio mais avançado da transição epidemiológica, tanto o Rio Grande do Sul como Santa Catarina, mas principalmente o Brasil, sofrem importante carga por doenças do subdesenvolvimento. As lesões representam o segundo grupo nos Estados e terceiro no Brasil. CONCLUSÃO: O indicador permite comparar agravos de alta e baixa letalidade, sendo instrumento útil na gestão e controle social das políticas e ações de saúde.
In Spain the reporting level of AIDS cases is acceptable for the aims of surveillance, although in some regions measures to improve it should be taken. The notification of deaths to the AIDS reporting system presents great deficiencies.
Disease burden due to vaccinable diseases is a good indicator of the health of the young population in Spain. This measure summarizes and combines information on mortality, morbidity and disability caused by diseases. The DALYs attributable to diseases included in the vaccination schedule demonstrate that immunization programs have achieved their goals.
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