Integrating equity and productivity in health evaluation

Abstract

This paper develops a unified framework for evaluating health outcomes that jointly incorporates equity and productivity. Extending beyond traditional QALYs, PALYs, and the more recent PQALYs, we introduce a broader class of evaluation functions that integrate equity- and productivity-sensitive conditions. By imposing several normative criteria, including independence from measurement scales and Pigou–Dalton transfer principles, we obtain tractable power-form representations. In balancing equity and efficiency, the framework provides a coherent foundation for assessing interventions in contexts where both health and productive capacity are at stake.