The use of the global activity limitation Indicator and healthy life years by member states and the European Commission

Abstract

BackgroundIn 2005, the European Union (EU) started to use a disability-free life expectancy, known as Healthy Life Years (HLY), to monitor progress in the strategic European policies such as the 2000 Lisbon strategy. HLY are based on the underlying measure: the Global Activity Limitation Indicator (GALI). Twelve years after its implementation, this study aims to assess its current use in EU Member States and the European Commission.MethodsIn March 2017, a questionnaire was sent to 28 Member states and the European Commission. The questionnaire inquired how the GALI and HLY are used to set policy targets, in which surveys the GALI has been introduced since 2005, how the GALI and HLY are presented, and what the capacity in each country is to investigate the GALI and HLY.ResultsThe survey was answered by 22 Member States and by the Commission. HLY are often used to set targets and develop strategies in health such as national health plans. Analysis of HLY has even led to policy change. In some countries, HLY have become the main indicator for health, gaining more importance than life expectancy. More recently, the GALI and HLY have also been used for policy targets outside the health sector such as in the area of pension and retirement age or in the context of sustainable development. Regarding surveys, the GALI is mostly obtained from the EU-SILC, SHARE and EHIS, but is also increasingly introduced in national surveys. National health reporting systems usually present HLY on their national statistics websites. Most countries have up to three specialists working on the GALI and HLY, which has been consistent through time. Others have increased their capacity over various institutions.ConclusionHLY is an indicator that is systematically used to monitor health developments in most EU countries. The SHARE, EU-SILC and EHIS are commonly used to assess HLY through the GALI. The results are then described in reports and presented on national statistics websites and used in different policy settings. Expertise to analyse the GALI and HLY is available in most countries.Electronic supplementary materialThe online version of this article (10.1186/s13690-018-0279-z) contains supplementary material, which is available to authorized users.

Biases in health expectancies due to educational differences in survey participation of older Europeans: It’s worth weighting for

“…HEX in Europe is most commonly calculated based on the Global Activity Limitation Indicator (GALI) [5,27,46,47], making the health measure the obvious choice for this analysis. Moreover, evaluations show that GALI similarly measures function and disability across European countries [48,49], allowing cross-country comparisons.…”

“…For example, the European Commission aims to add 2 years of healthy life for the average European between 2010/2011 and 2020 to improve the sustainability of the European social and healthcare systems [3,4]. Furthermore, many European governments use HEX to set health-related targets and make policy changes based on this measure [5].…”

How can we monitor the impact of national health information systems? Results from a scoping review

“…Therefore, monitoring HI system use within healthcare facilities, and institutions is the third domain in our framework ( figure 1 ) which we refer to as ‘Stakeholder Engagement’. The increasing use of multidimensional and composite indicators such as the Healthy Life Years , 13 and the Disability Adjusted Life Years illustrate the need for HI systems to provide data that resonate with the complex problems that policy-makers face in health. 126 Yet, the lack of joint understanding can negatively influence the KT process, and the sustainability of evidence-based interventions in the field.…”

“… 11 In this context, we define impact as the demonstrated use of evidence by stakeholders for decision-making and intervention in public health policy and practice. 1 , 12 –14 …”

Potential impact of reduced tobacco use on life and health expectancies in Belgium

“…Healthy life years, also known as disability-free life expectancy, is an indicator based on limitations in daily activities and measures how many years an individual at a particular age is, on average, expected to live without disability (Robine et al 1999). Due to population aging, increasing healthy life years is a main policy objective in the EU and in several member states including Belgium (Lagiewka 2012;Obyn et al 2017;Bogaert et al 2018). There is, however, little evidence on how reduced tobacco use may contribute to achieving the EU policy goal of increasing healthy life years, as most studies focused on effects on disease-specific incidence and mortality, overall life expectancy, or health-adjusted life years (e.g., Holm et al 2014;Lhachimi et al 2016;Singh et al 2019).…”