J Prev Med Public Health.  2010 Mar;43(2):174-184. 10.3961/jpmph.2010.43.2.174.

Assessment of Applicability of Standardized Rates for Health State Comparison Among Areas: 2008 Community Health Survey

• Kwon GY
• Lim DS
• Park EJ
• Jung JS
• Kang KW
• Kim YA
• Kim H
• Cho SI

• KMID: 1070502
• DOI: http://doi.org/10.3961/jpmph.2010.43.2.174

Abstract

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.

Keyword

Age distribution; Health surveys; Population characteristics; Standardization

MeSH Terms

Adolescent
Adult
Age Distribution
Aged
Female
Health Status
Humans
Male
Middle Aged
Population Surveillance/*methods
Republic of Korea/epidemiology
Small-Area Analysis
Young Adult