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Assessment of Applicability of Standardized Rates for Health State Comparison Among Areas: 2008 Community Health Survey

지역 간 건강수준 비교를 위한 표준화율 적용의 적절성 평가: 2008년 지역사회건강조사를 바탕으로

  • Kwon, Geun-Yong (School of Public Health, Seoul National University) ;
  • Lim, Do-Sang (Korea Center for Diease Control and Prevention) ;
  • Park, Eun-Ja (Korea Institute for Health and Social Affairs) ;
  • Jung, Ji-Sun (School of Public Health, Seoul National University) ;
  • Kang, Ki-Won (School of Public Health, Seoul National University) ;
  • Kim, Yun-A (Korea Center for Diease Control and Prevention) ;
  • Kim, Ho (School of Public Health, Seoul National University) ;
  • Cho, Seong-Il (School of Public Health, Seoul National University)
  • Received : 2009.09.08
  • Accepted : 2009.12.03
  • Published : 2010.03.31

Abstract

Objectives: This study shows the issues that should be considered when applying standardized rates using Community Health Survey(CHS) data. Methods: We analyzed 2008 CHS data. In order to obtain the reliability of standardized rates, we calculated z-score and rank correlation coefficients between direct standardized rate and indirect standardized rate for 31 major indices. Especially, we assessed the change of correlations according to population composition (age and sex), and characteristics of the index. We used Mantel-Haenszel chi-square to quantify the difference of population composition. Results: Among 31 major indices, 29 indices' z-score and rank correlation coefficients were over 0.9. However, regions with larger differences in population composition showed lower reliability. Low reliability was also observed for the indices specific to subgroups with small denominator such as 'permanent lesion from stroke', and the index with large regional variations in age-related differences such as 'obtaining health examinations'. Conclusions: Standardized rates may have low reliability, if comparison is made between areas with extremely large differences in population composition, or for indicies with large regional variations in age-related differences. Therefore, the special features of standardized rates should be considered when health state are compared among areas.

Keywords

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