Utility of Health Expectancy When Evaluating Health Care Systems

  • Matthew C. StiefelEmail author
Part of the International Handbooks of Population book series (IHOP, volume 9)


This chapter includes a discussion of the contributions of health care to health outcomes in the context of the determinants of health framework, current and potential applications of health expectancies by health care systems, barriers to those applications and opportunities to overcome the barriers. As the world of health care expands to include upstream determinants and downstream outcomes, health expectancies are increasingly well-suited to shed light on this expanded field of view. Health expectancies provide an intuitive and meaningful summary outcome measure combining the length and quality of life that can enable informed health care decisions at both the individual and population levels. There is growing interest among health care systems in using health expectancies in a variety of applications, including research/clinical, planning/operations, and mission/strategy/policy. Health care systems are uniquely positioned to provide the clinical and administrative data for health expectancies that utilize diagnosis information to calculate disability weights and potentially test new measures of health status that combine clinical and self-report measures. Barriers to full adoption of health expectancies among health care systems remain, including issues related to actionability and data availability. Recent developments, including small area estimation techniques, new methods for assessing health status at the point of care and through mobile technology and novel techniques for calculating health expectancies at the individual level and predicting mortality, address these barriers. These developments, together with existing structural advantages of health care systems, provide promise for greater health care system adoption of health expectancies.


Health care Clinical systems Operational systems Health expectancy applications 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Center for Population HealthKaiser Permanente Care Management InstituteOaklandUSA

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