OBJECTIVES: : Healthy life expectancies are systematically calculated in the EU countries using the Sullivan method. The Sullivan health expectancy index combines age-specific mortality rates and age-specific % of prevalence of healthy life. The main limitation is that the progressive deterioration of health throughout life remains undisclosed. A second important limitation is that prevalence data depends on expensive national health surveys. The objective of this work is to obtain an equivalent estimation of healthy life expectancy, considering multiple health states, but using available morbidity and mortality data.

METHODS: Mortality and morbidity information, corresponding to years 2016 and 2017, was obtained for the population of the county of Baix Empordà (Girona), N = 91,130. The set of individual information on diagnoses, procedures and pharmacy consumption contained in the individual clinical record (ICD and ATC codes), were classified into health states according to the 3M-Clinical Risk Groups. The information analysed included acute inpatient care, acute outpatient care, primary care, pharmacy prescriptions, diagnostic tests, emergencies and long-term residential care services. Based on the health transitions observed between 2016 and 2017, life expectancies by health state were obtained from a microsimulation model.

RESULTS

: Life expectancies at birth and 65 years were E^female=85.67, E^male=80.43, E^female=21.25, E^male=16.61. Healthy life expectancies at birth and 65 years were HE^female=39.95, HE^male=42.92, HE^female=2.46 , HE^male=1.90. Life expectancies were totally consistent with the official estimates for 2016. Healthy life expectancies substantially differed from the last official estimates based on self-reported health surveys and the calculation method of prevalence.

CONCLUSIONS

: The decomposition of life expectancies into morbidity profiles can be efficiently obtained from multistate models based on clinical information and can be very useful in monitoring the population according to their health status, in a health services management context. The figures obtained are not comparable with those calculated with the Sullivan method.