Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2021 Jan 11;36(2):e8. doi: 10.3346/jkms.2021.36.e8.
Health indicators, such as mortality rates or life expectancy, need to be presented at the local level to improve the health of local residents and to reduce health inequality across geographic areas. The aim of this study was to estimate life expectancy at the district level in Korea through a spatio-temporal analysis.
Spatio-temporal models were applied to the National Health Information Database of the National Health Insurance Service to estimate the mortality rates for 19 age groups in 250 districts from 2004 to 2017 by gender in Korea. Annual district-level life tables by gender were constructed using the estimated mortality rates, and then annual district-level life expectancy by gender was estimated using the life table method and the Kannisto-Thatcher method. The annual district-level life expectancies based on the spatio-temporal models were compared to the life expectancies calculated under the assumption that the mortality rates in these 250 districts are independent from one another.
In 2017, district-level life expectancy at birth ranged from 75.5 years (95% credible interval [CI], 74.0-77.0 years) to 84.2 years (95% CI, 83.4-85.0 years) for men and from 83.9 years (95% CI, 83.2-84.6 years) to 88.2 years (95% CI, 87.3-89.1 years) for women. Between 2004 and 2017, district-level life expectancy at birth increased by 4.57 years (95% CI, 4.49-4.65 years) for men and by 4.06 years (95% CI, 3.99-4.12 years) for women. To obtain stable annual life expectancy estimates at the district level, it is recommended to use the life expectancy based on spatio-temporal models instead of calculating life expectancy using observed mortality.
In this study, we estimated the annual district-level life expectancy from 2004 to 2017 in Korea by gender using a spatio-temporal model. Local governments could use annual district-level life expectancy estimates as a performance indicator of health policies to improve the health of local residents. The approach to district-level analysis with spatio-temporal modeling employed in this study could be used in future analyses to produce district-level health-related indicators in Korea.
为了改善当地居民的健康状况并减少不同地理区域之间的健康不平等，需要在地方层面上呈现健康指标，如死亡率或预期寿命。本研究旨在通过时空分析来估计韩国各地区的预期寿命。
利用国家健康保险服务的国家健康信息数据库，应用时空模型，按性别估计了 2004 年至 2017 年期间韩国 250 个地区 19 个年龄组的死亡率。利用估计的死亡率为各年龄组构建了年度地区生命表，然后利用生命表法和 Kannisto-Thatcher 法估算了各年龄组的年度地区预期寿命。将基于时空模型的年度地区预期寿命与假设这 250 个地区的死亡率彼此独立的计算得出的预期寿命进行了比较。
2017 年，男性的出生时预期寿命从 75.5 岁（95%可信区间[CI]：74.0-77.0 岁）到 84.2 岁（95%CI：83.4-85.0 岁）不等，女性的出生时预期寿命从 83.9 岁（95%CI：83.2-84.6 岁）到 88.2 岁（95%CI：87.3-89.1 岁）不等。2004 年至 2017 年间，男性的出生时预期寿命增加了 4.57 岁（95%CI：4.49-4.65 岁），女性的出生时预期寿命增加了 4.06 岁（95%CI：3.99-4.12 岁）。为了获得稳定的年度地区预期寿命估计值，建议使用基于时空模型的预期寿命，而不是使用观察到的死亡率来计算预期寿命。
本研究使用时空模型按性别估计了 2004 年至 2017 年韩国的年度地区预期寿命。地方政府可以将年度地区预期寿命估计值用作改善当地居民健康状况的卫生政策绩效指标。本研究中采用的时空建模地区分析方法可用于未来的分析，以在韩国产生与健康相关的地区指标。
