Journal of Preventive Medicine and Public Health

Special Article

Updating Korean Disability Weights for Causes of Disease: Adopting an Add-on Study Method: Dasom Im, Noor Afif Mahmudah, Seok-Jun Yoon, Young-Eun Kim, Don-Hyung Lee, Yeon-hee Kim, Yoon-Sun Jung, Minsu Ock; J Prev Med Public Health. 2023;56(4):291-302. Published online June 26, 2023; DOI: https://doi.org/10.3961/jpmph.23.192

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Abstract Summary PDF Supplementary Material

Objectives
Disability weights require regular updates, as they are influenced by both diseases and societal perceptions. Consequently, it is necessary to develop an up-to-date list of the causes of diseases and establish a survey panel for estimating disability weights. Accordingly, this study was conducted to calculate, assess, modify, and validate disability weights suitable for Korea, accounting for its cultural and social characteristics.
Methods
The 380 causes of disease used in the survey were derived from the 2019 Global Burden of Disease Collaborative Network and from 2019 and 2020 Korean studies on disability weights for causes of disease. Disability weights were reanalyzed by integrating the findings of an earlier survey on disability weights in Korea with those of the additional survey conducted in this study. The responses were transformed into paired comparisons and analyzed using probit regression analysis. Coefficients for the causes of disease were converted into predicted probabilities, and disability weights in 2 models (model 1 and 2) were rescaled using a normal distribution and the natural logarithm, respectively.
Results
The mean values for the 380 causes of disease in models 1 and 2 were 0.488 and 0.369, respectively. Both models exhibited the same order of disability weights. The disability weights for the 300 causes of disease present in both the current and 2019 studies demonstrated a Pearson correlation coefficient of 0.994 (p=0.001 for both models). This study presents a detailed add-on approach for calculating disability weights.
Conclusions
This method can be employed in other countries to obtain timely disability weight estimations.

Summary

Korean summary
이 연구에서는 장애보정생존연수의 산출 방법론 중 발생률 기반 접근법을 이용하여 질병부담 산출에 활용할 질병원인에 대한 장애가중치를 산출하고 한국의 문화사회적 특징을 고려하여 이에 대한 타당성을 검증하였다. 특히, 지난 연구에서 활용한 질병원인에 대한 장애가중치 결과값을 add-on study 방법으로 활용하여 장애가중치를 개정하였다. 이번 연구에서 수행한 add-on study 방법을 활용하여 장애가중치 값을 산출할 경우 다수의 전문가의 누적된 의견을 기반으로 장애가중치를 안정적으로 개정하여 특정 질병원인의 장애보정생존연수를 보다 정확하게 산출할 수 있게 될 것이다.

Citations

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Trends in Healthy Life Expectancy (HALE) and Disparities by Income and Region in Korea (2008–2020): Analysis of a Nationwide Claims Database
Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
Journal of Korean Medical Science.2024;[Epub] CrossRef
Measuring the Burden of Disease in Korea Using Disability-Adjusted Life Years (2008–2020)
Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
Journal of Korean Medical Science.2024;[Epub] CrossRef

Reviews

DALY Estimation Approaches: Understanding and Using the Incidence-based Approach and the Prevalence-based Approach: Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon; J Prev Med Public Health. 2022;55(1):10-18. Published online January 19, 2022; DOI: https://doi.org/10.3961/jpmph.21.597

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Abstract Summary PDF

Disability-adjusted life-year (DALY) estimates may vary according to factors such as the standard life expectancy, age weighting, time preference and discount rate, calculation of disability weights, and selection of the estimation method. DALY estimation methods are divided into the following 3 approaches: the incidence-based approach, the pure prevalence-based approach, and the hybrid approach. These 3 DALY estimation approaches each reflect different perspectives on the burden of disease using unique characteristics, based on which the selection of a suitable approach may vary by the purpose of the study. The Global Burden of Disease studies, which previously estimated DALYs using the incidence-based approach, switched to using the hybrid approach in 2010, while the National Burden of Disease studies in Korea still mainly apply the incidence-based approach. In order to increase comparability with other international burden of disease studies, more DALY studies using the prevalence-based approach need to be conducted in Korea. However, with the limitations of the hybrid approach in mind, it is necessary to conduct more research using a disease classification system suitable for Korea. Furthermore, more detailed and valid data sources should be established before conducting studies using a broader variety of DALY estimation approaches. This review study will help researchers on burden of disease use an appropriate DALY estimation approach and will contribute to enhancing researchers’ ability to critically interpret burden of disease studies.

Summary

Korean summary
장애보정생존연수 산출 방법은 발생률 접근법, 순수 유병률 접근법 및 하이브리드 접근법으로 나뉜다. 이러한 3가지 장애보정생존연수 산출 접근법은 각각 고유한 특성을 가지고 질병부담에 대한 다양한 관점을 반영하기 때문에, 연구 목적에 따라 산출 접근법의 선택이 달라질 수 있다. 이번 연구의 결과는 연구자들이 장애보정생존연수 산출 방법의 타당성을 향상시키기 위하여 질병부담 연구에 사용할 산출 접근법을 결정하는 데 도움이 될 것이다.

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A Review of the Types and Characteristics of Healthy Life Expectancy and Methodological Issues: Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon; J Prev Med Public Health. 2022;55(1):1-9. Published online January 16, 2022; DOI: https://doi.org/10.3961/jpmph.21.580

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361 Download
12 Web of Science
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Abstract Summary PDF

An index that evaluates the health level of a population group considering both death and loss of function due to disease is called a summary measure of population health (SMPH). SMPHs are broadly divided into life year indices and life expectancy indices, the latter of which comprise healthy life expectancy (HLE). HLE is included as a policy target in various national and regional level healthcare plans, and the term “HLE” is commonly used in academia and by the public. However, the overall level of understanding of HLE—such as the precise definition of HLE and methods of calculating HLE—still seems to be low. As discussed in this study, the types of HLE are classified into disability-free life expectancy, disease-free life expectancy, quality-adjusted life expectancy, self-rated HLE, and disability-adjusted life expectancy. Their characteristics are examined to facilitate a correct understanding and appropriate utilization of HLE. In addition, the Sullivan method, as a representative method for calculating HLE, is presented in detail, and major issues in the process of calculating HLE, such as selection of the population group and age group, estimation of death probability, calculation of life years, and incorporation of health weights, are reviewed. This study will help researchers to select an appropriate HLE type and evaluate the validity of HLE research results, and it is expected to contribute to the vitalization of HLE research.

Summary

Korean summary
건강수명의 유형은 무장애기대수명, 질병 없는 기대수명, 질보정기대수명, 자가평가보정 기대수명, 장애보정기대수명으로 분류된다. 건강수명의 올바른 이해와 적절한 활용을 돕기 위해 이들의 특성을 검토하였다. 이번 연구는 연구자들이 적절한 건강수명 유형을 선택하고 건강수명 연구 결과의 타당성을 평가하는 데 도움이 될 것이며, 건강수명 연구의 활성화에 기여할 것으로 기대된다.

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Special Article

Measuring the Burden of Disease in Korea, 2008-2018: Yoon-Sun Jung, Young-Eun Kim, Hyesook Park, In-Hwan Oh, Min-Woo Jo, Minsu Ock, Dun-Sol Go, Seok-Jun Yoon; J Prev Med Public Health. 2021;54(5):293-300. Published online September 30, 2021; DOI: https://doi.org/10.3961/jpmph.21.478

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398 Download
27 Crossref

Abstract Summary PDF Supplementary Material

The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.

Summary

Korean summary
이 논문에서는 장애보정생존년수라는 지표를 활용하여 2008-2018년 한국인의 질병부담 산출결과를 제시하였으며, 성별·연령군별·질환별 질병부담 수준의 차이 뿐만 아니라 지역 및 소득수준의 사회경제적 수준에 따른 질병부담의 격차도 함께 제시하였다.

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