Department of Big Data Strategy, National Health Insurance Service, 32 Geongang-ro, Wonju 26464, Korea.
Department of Public Health, Graduate School, Korea University, 73, Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea.
Int J Environ Res Public Health. 2021 Mar 27;18(7):3473. doi: 10.3390/ijerph18073473.
This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability (YLD) from the national claims data, as well as to identify the differences and inequalities in income level and region. The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based YLD for 260 disease groups, and used it as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 Korean municipal-level administrative districts. Our results revealed that HALE increased from 2008 to 2018. HALE in males increased faster than that in females. HALE was higher in higher income levels. In 2018, the gap in HALE between Q1 and Q2, the lower income group, was about 5.57 years. The gap in females by income level was smaller than that in males. Moreover, the gap in HALE by region was found to increase. Results suggest that there is an inequality in YLD in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.
本研究旨在利用国家索赔数据中的伤残调整生命年(YLD)来计算健康调整生命年(HALE),并确定收入水平和地区的差异和不平等。该研究针对接受健康保险和医疗福利的全部人口进行。我们计算了 260 种疾病组别的基于发病率的 YLD,并将其作为丧失健康年数来计算 HALE。我们采用保险费作为收入的代理指标。对于地区分类,我们选择了 250 个韩国市级行政区域。研究结果表明,HALE 从 2008 年到 2018 年有所增加。男性的 HALE 增长速度快于女性。高收入水平的 HALE 较高。2018 年,收入较低的 Q1 和 Q2 组之间的 HALE 差距约为 5.57 年。女性的收入水平差距小于男性。此外,发现地区间 HALE 的差距在增加。结果表明,韩国在收入水平方面存在 YLD 不平等现象。因此,我们需要对低收入群体进行密集管理,以促进国家层面的 HALE 提高。