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J Prev Med Public Health > Volume 43(2); 2010 > Article
Journal of Preventive Medicine and Public Health 2010;43(2): 174-184. doi: https://doi.org/10.3961/jpmph.2010.43.2.174
Assessment of Applicability of Standardized Rates for Health State Comparison Among Areas: 2008 Community Health Survey.
Geun Yong Kwon, Do Sang Lim, Eun Ja Park, Ji Sun Jung, Ki Won Kang, Yun A Kim, Ho Kim, Sung Il Cho
1School of Public Health, Seoul National University, Korea. scho@snu.ac.kr
2Korea Center for Diease Control and Prevention, Korea.
3Korea Institute for Health and Social Affairs, Korea.
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.
Key words: Age distribution; Health surveys; Population characteristics; Standardization
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