Construction and evaluation of a practical model for measuring health-adjusted life expectancy (HALE) in China.

BACKGROUND: HALE is now a regular strategic planning indicator for all levels of the Chinese government. However, HALE measurements necessitate comprehensive data collection and intricate technology. Therefore, effectively converting numerous diseases into the years lived with disability (YLD) rate is a significant challenge for HALE measurements. Our study aimed to construct a simple YLD rate measurement model with high applicability based on the current situation of actual data resources within China to address challenges in measuring HALE target values during planning. METHODS: First, based on the Chinese YLD rate in the Global Burden of Disease (GBD) 2019, Pearson correlation analysis, the global optimum method, etc., was utilized to screen the best predictor variables from the current Chinese data resources. Missing data for predictor variables were filled in via spline interpolation. Then, multiple linear regression models were fitted to construct the YLD rate measurement model. The Sullivan method was used to measure HALE. The Monte Carlo method was employed to generate 95% uncertainty intervals. Finally, model performances were assessed using the mean absolute error (MAE) and mean absolute percentage error (MAPE). RESULTS: A three-input-parameter model was constructed to measure the age-specific YLD rates by sex in China, directly using the incidence of infectious diseases, the incidence of chronic diseases among persons aged 15 and older, and the addition of an under-five mortality rate covariate. The total MAE and MAPE for the combined YLD rate were 0.0007 and 0.5949%, respectively. The MAE and MAPE of the combined HALE in the 0-year-old group were 0.0341 and 0.0526%, respectively. There were slightly fewer males (0.0197, 0.0311%) than females (0.0501, 0.0755%). CONCLUSION: We constructed a high-accuracy model to measure the YLD rate in China by using three monitoring indicators from the Chinese national routine as predictor variables. The model provides a realistic and feasible solution for measuring HALE at the national and especially regional levels, considering limited data.

Evaluation and Estimation of the Provincial Infant Mortality Rate in China's Sixth Census.

OBJECTIVE: To assess the data quality and estimate the provincial infant mortality rate (1q0) from China's sixth census. METHODS: A log-quadratic model is applied to under-fifteen data. We analyze and compare the average relative errors (AREs) for 1q0 between the estimated and reported values using the leave-one-out cross-validation method. RESULTS: For the sixth census, the AREs are more than 100% for almost all provinces. The estimated average 1q0 level for 31 provinces is 12.3‰ for males and 10.7‰ for females. CONCLUSION: The data for the provincial 1q0 from China's sixth census have a serious data quality problem. The actual levels of 1q0 for each province are significantly higher than the reported values.