We obtained two different approximations to the concept of HLE. A first aspect to discuss is the different concept of health embedded in the two approaches compared in the article. The significant difference in the results is simply a reflection of such different conception of health status. Beyond the World Health Organization’s (WHO) definition of health from 1947 “… complete physical, mental and social wellbeing…”, difficulty in establishing a common and uniform concept of health was reported in the literature. Recent approaches considered, heath care organisations, health care workers and patients as different actors with a non-uniform perspective over health. Moreover, focusing on the patient context, the self-perception of health is a psychological and cultural convention susceptible to significant variability among individuals. Other authors conclude that the inference of health status from clinical records on attended morbidity approximates to the subjective perception of health and vice versa. However, certain socio-demographic factors modulate the individual perception. Different studies described only moderate or fair agreement comparing self-reported morbidity and pharmacy prescription. Individual factors such as age, gender, marital status, education, poor-delayed recall, depression and polypharmacy were significantly associated with discordance between morbidity measures. The research team considered to calculate the specific HLE-Sullivan estimate for the study population (instead of the global Catalan estimate), since it was feasible from the data available. Although, it would result in a more precise HLE estimate, since the focus of the study is the alternative multistate micro simulation method, the choice of the team was not to go further on the Sullivan estimates. Throughout the study we proposed a new approach to the concept of healthy life based on available data. The same perspective can be also applicable to other Health Expectancies based on surveys, for example disability-free Life (less subjective and more related to legal or country system characteristics), without chronic morbidity or active life health expectancies.

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