A health economist compares two summary measures of population health. Which statement correctly distinguishes the Quality Adjusted Life Year (QALY) from the Disability Adjusted Life Year (DALY)?

• A Both measure health gap, where a higher value means worse health
• B DALY incorporates societal preferences for health states through utility weights, whereas QALY uses disability weights
• C QALY is used only for fatal conditions, whereas DALY applies to non-fatal conditions
• D QALY combines survival with quality of life, and a higher QALY indicates better health, whereas DALY quantifies health lost, and a lower DALY is better ✓

Explanation

QALY is a health gain measure: years of life weighted by quality-of-life utility, so more QALYs mean better outcomes and it is widely used in cost-utility analysis of interventions. DALY is a health gap measure: the sum of years of life lost and years lived with disability, so fewer DALYs indicate less disease burden. Option B reverses the two instruments, since DALYs use disability weights and QALYs use utilities.

Reference: Park's Textbook of Preventive and Social Medicine, 25th ed.

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