Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Adjustment for Multimorbidity in Estimations of the Burden of Diseases Using Korean NHIS Data

  • Shin, Yoonhee (Advanced Biomedical Research Institute, Seoul Hospital, Ewha Womans University) ;
  • Choi, Eun Jeong (Department of Preventive Medicine, Ewha Womans University College of Medicine) ;
  • Park, Bomi (Department of Preventive Medicine, Chung-Ang University College of Medicine) ;
  • Lee, Hye Ah (Clinical Trial Center, Mokdong Hospital, Ewha Womans University) ;
  • Lee, Eun-Kyung (Department of Statistics, Ewha Womans University) ;
  • Park, Hyesook (Department of Preventive Medicine, Ewha Womans University College of Medicine)
  • Received : 2021.11.02
  • Accepted : 2022.01.24
  • Published : 2022.02.03
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Abstract

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.

Keywords

Acknowledgement

This research was supported by a grant from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Korea (study number HI18C0446 and REQ000046576-001).

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