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Eun-Kyung Lee 1 Article
Adjustment for Multimorbidity in Estimations of the Burden of Diseases Using Korean NHIS Data
Yoonhee Shin, Eun Jeong Choi, Bomi Park, Hye Ah Lee, Eun-Kyung Lee, Hyesook Park
J Prev Med Public Health. 2022;55(1):28-36.   Published online January 31, 2022
DOI: https://doi.org/10.3961/jpmph.21.583
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AbstractAbstract AbstractSummary PDFSupplementary Material
The current multimorbidity correction method in the Global Burden of Disease studies assumes the independent occurrence of diseases. Those studies use Monte-Carlo simulations to adjust for the presence of multiple disease conditions for all diseases. The present study investigated whether the above-mentioned assumption is reasonable based on the prevalence confirmed from actual data. This study compared multimorbidity-adjusted years of lived with disability (YLD) obtained by Monte-Carlo simulations and multimorbidity-adjusted YLD using multimorbidity prevalence derived from National Health Insurance Service data. The 5 most common diseases by sex and age groups were selected as diseases of interest. No significant differences were found between YLD estimations made using actual data and Monte-Carlo simulations, even though assumptions about the independent occurrence of diseases should be carefully applied. The prevalence was not well reflected according to disease characteristics in those under the age of 30, among whom there was a difference in YLD between the 2 methods. Therefore, when calculating the burden of diseases for Koreans over the age of 30, it is possible to calculate the YLD with correction for multimorbidity through Monte-Carlo simulation, but care should be taken with under-30s. It is useful to apply the efficiency and suitability of calibration for multiplicative methods using Monte-Carlo simulations in research on the domestic disease burden, especially in adults in their 30s and older. Further research should be carried out on multimorbidity correction methodology according to the characteristics of multiple diseases by sex and age.
Summary
Korean summary
질병부담 산출 시 몬테카를로 시뮬레이션을 통한 복합질환 보정 방법에 대해 다빈도 질환 실제 데이터 기반으로 검증해 봄으로써 30세 이상 연령에서 추정값에 큰 차이가 없음을 확인하였다. 하지만 30세 미만에서는 포함되는 질환 종류에 따라 실제 데이터 기반으로 복합질환을 보정하는 것이 불가능하거나 시뮬레이션으로 구한 값이 부정확하였다. 따라서, 질환 특성을 반영한 복합질환 보정방법론 개발이 필요함을 제안하며 본 연구 결과는 한국인 질병부담 연구에서 몬테카를로 시뮬레이션을 이용한 복합질환 보정 방법의 활용근거로 사용될 수 있을 것이다.

JPMPH : Journal of Preventive Medicine and Public Health