History and development of national burden of disease assessment in Australia
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COMMENTARY
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History and development of national burden of disease assessment in Australia Lynelle Moon1* , Michelle Gourley1, John Goss2, Miriam Lum On1, Paula Laws1, Anna Reynolds1 and Richard Juckes1
Abstract Australia’s 1996 national burden of disease (BoD) study was one of the first in the world and updates have continued over the following two decades with the fifth study now underway. The studies adapt the global framework most recently implemented by the Global Burden of Disease Study and the World Health Organization to suit Australia’s specific needs, producing estimates of fatal and non-fatal burden via the Disability Adjusted Life Year (DALY) metric, as well as attribution of the burden to many risk factors. Detailed Australian data are used with minimal reliance on modelling to fill data gaps. Comprehensive estimates are produced, including for the Indigenous population, for each of the eight states and territories, the five remoteness areas and five socioeconomic quintiles. A number of method developments have been made as part of these studies, including redistribution of deaths data and a detailed quality framework for describing the robustness of the underlying data and methods. Data and methods continue to be refined as part of the studies, and developments in global studies and other national studies are incorporated where appropriate. Keywords: Burden, Disease, Australia, DALY, Method, Deaths, Risk factors
Background Australia has been at the forefront of national burden of disease study development for more than 20 years. The Australian study for the 1996 reference year [1] was one of the first national-level burden of disease studies, along with those for Mexico, Mauritius and the Netherlands [2– 4]. There have been periodic Australian studies completed since then, with the latest for the 2015 reference year [5]. All of the studies have been based at, or done in partnership with, the Australian Institute of Health and Welfare (AIHW), an independent government agency. Each study has been conducted in collaboration with many Australian experts, with the 2003 study in particular being conducted with the University of Queensland [6].
As a result of the initial studies, national and state/territory governments across Australia have become interested in using the burden of disease framework to help quantify health status and needs. There have also been advances in methods over the years and greater interest among health policy makers in information about burden of disease in particular population groups. This has stimulated the need for revised and continued Australian burden of disease studies to update and extend the initial efforts. This paper describes the background of burden of disease work in Australia, a number of developments made (including use of direct data as much as possible, deaths redistribution, and a quality framework) and challenges faced over the years. The impact of the studies is also discussed.
* Correspondence: [email protected] 1 Health Group, Australi
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