La qualité de vie peut-elle guider les choix de planification sanitaire ? Les QALYs ou l'essai non transformé de l'Angleterre

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Abstract
Alain Jourdain: Can quality of life contribute to health planning? QALYs or the english unconverted try. Quality Adjusted Life Years (QALYs) have been used for decision making in the field of new technologies at regional level in UK and USA. This tool is now disputed; the aim of this article is to make an evaluation of its usefullness. In the first part, QALYs are presented as an original contribution to the battery of synthetic health indicators like life expectancy or life expectancy without disability. In the second part, QALYs/cost are discussed from the micro-economic point of view. We set in the discussion that QALYs, now, suffer of a lack of conception and experience that could be compensated by a better dialogue between economists and clinicians. This effort is justified because this tool allows a transfer of responsabilities from specialists towards civil society. And QALYs have an advantage on other utility-cost indicators: they are built as a "lego System", the elements of which can be found in the scientific litterature.

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