Health care spending in the U.S. grew two trillion dollars from 1987 to 2010, a 400% increase, but our understanding of the value of that increase is limited. In this paper we estimate the net value of spending for thirty chronic diseases between 1987 and 2010 by assigning a monetary value to changes in health outcomes and relating it to the costs of treating each disease. Changes in health outcomes are measured using a newly-available time series of disability adjusted life years (DALYs) data from the Institute for Health Metrics and Evaluation. Spending on treatments are determined using health care expenditure data from nationally representative surveys. We find the net value of treatment has grown substantially for several diseases. Overall, 20 of the 30 chronic conditions studied experienced an increase in health outcomes over the period, with 8 of those 20 showing a decrease in per-patient spending. Our estimates of net value of health spending using DALYs data are simple to apply and results are generally consistent with previous estimates which usually involve onerous data collection methods to study a single disease. The DALYs data have potential to be a useful, low-cost way to measure changes in health outcomes. However, challenges remain in using DALYs data to accurately measure the changing value of health care spending on the treatment of disease.

中文翻译：

---

从1987年到2010年，使用残疾调整生命年来评估美国三十种慢性病的治疗价值：概念验证。

从1987年到2010年，美国的医疗保健支出增长了2万亿美元，增长了400％，但我们对这种增长的价值的了解有限。在本文中，我们通过为健康结果的变化分配货币价值并将其与每种疾病的治疗成本相关联，来估算1987年至2010年间30种慢性疾病的支出净值。健康状况的变化是使用来自健康指标与评估研究所的最新可用时间序列的残疾调整生命年（DALYs）数据来衡量的。使用国家代表性调查中的医疗保健支出数据确定治疗支出。我们发现几种疾病的治疗净值已大大提高。总体而言，在此期间研究的30种慢性病中，有20种的健康状况有所改善，其中20人中有8人的人均医疗费用有所下降。我们使用DALYs数据估算卫生支出的净值很容易应用，其结果通常与以前的估算相符，后者通常涉及繁重的数据收集方法来研究单一疾病。DALYs数据可能是一种有用的低成本方法，可以衡量健康结果的变化。但是，使用DALYs数据准确测量医疗保健支出在疾病治疗上的价值变化仍然存在挑战。衡量健康结果变化的低成本方法。但是，使用DALYs数据准确测量医疗保健支出在疾病治疗上的价值变化仍然存在挑战。衡量健康结果变化的低成本方法。但是，使用DALYs数据准确测量医疗保健支出在疾病治疗上的价值变化仍然存在挑战。