지역 간 건강수준 비교를 위한 표준화율 적용의 적절성 평가: 2008년 지역사회건강조사를 바탕으로 (Assessment of Applicability of Standardized Rates for Health State omparison Among Areas: 2008 Community Health Survey)

서지정보

· 발행기관 : 대한예방의학회
· 수록지 정보 : 예방의학회지 / 43권 / 2호 / 174 ~ 184페이지
· 저자명 : 권근용, 임도상, 박은자, 정지선, 강기원, 김윤아, 김호, 조성일

초록

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.

영어초록

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.

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