An Evaluation of Sampling Design for Estimating an Epidemiologic Volume of Diabetes and for Assessing Present Status of Its Control in Korea.

Lee, Ji Sung; Kim, Jaiyong; Baik, Sei Hyun; Park, Ie Byung; Lee, Juneyoung

doi:2009.42.2.135

J Prev Med Public Health > Volume 42(2); 2009 > Article

Evaluation Studies

Journal of Preventive Medicine and Public Health 2009;42(2): 135-142. doi: https://doi.org/10.3961/jpmph.2009.42.2.135

An Evaluation of Sampling Design for Estimating an Epidemiologic Volume of Diabetes and for Assessing Present Status of Its Control in Korea.

Ji Sung Lee, Jaiyong Kim, Sei Hyun Baik, Ie Byung Park, Juneyoung Lee

¹Department of Public Health, Korea University Graduate School, Korea.
²Department of Social and Preventive Medicine, College of Medicine, Hallym University, Korea.
³Department of Internal Medicine, College of Medicine, Korea University, Korea.
⁴Department of Endocrinology of Metabolism, Gachon University of Science and Medicine, Korea.
⁵Department of Biostatistics, College of Medicine, Korea University, Korea. jyleeuf@korea.ac.kr

ABSTRACT

OBJECTIVES: An appropriate sampling strategy for estimating an epidemiologic volume of diabetes has been evaluated through a simulation. METHODS: We analyzed about 250 million medical insurance claims data submitted to the Health Insurance Review & Assessment Service with diabetes as principal or subsequent diagnoses, more than or equal to once per year, in 2003. The database was re-constructed to a 'patient-hospital profile' that had 3,676,164 cases, and then to a 'patient profile' that consisted of 2,412,082 observations. The patient profile data was then used to test the validity of a proposed sampling frame and methods of sampling to develop diabetic-related epidemiologic indices. RESULTS: Simulation study showed that a use of a stratified two-stage cluster sampling design with a total sample size of 4,000 will provide an estimate of 57.04% (95% prediction range, 49.83 - 64.24%) for a treatment prescription rate of diabetes. The proposed sampling design consists, at first, stratifying the area of the nation into "metropolitan/city/county" and the types of hospital into "tertiary/secondary/primary/clinic" with a proportion of 5:10:10:75. Hospitals were then randomly selected within the strata as a primary sampling unit, followed by a random selection of patients within the hospitals as a secondly sampling unit. The difference between the estimate and the parameter value was projected to be less than 0.3%. CONCLUSIONS: The sampling scheme proposed will be applied to a subsequent nationwide field survey not only for estimating the epidemiologic volume of diabetes but also for assessing the present status of nationwide diabetes control.

Key words: Simulation; Diabetes mellitus; Epidemiologic indices; Insurance claim review data; Stratified two-stage cluster sampling