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- Original Article Multimorbidity adjusted years lost to disability rates calculated through Monte-Carlo simulation in Korea
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Yoonhee Shin1,2
, Eun Jeong Choi1
, Bomi Park3
, Hye Ah Lee4
, Eun-Kyung Lee5
, Hyesook Park1,6
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Epidemiol Health 2022;44e2022090-0
DOI: https://doi.org/10.4178/epih.e2022090
Published online: October 17, 2022
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2College of Nursing, Ewha Womans University, Seoul, Korea
3Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
4Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Korea
5Department of Statistics, Ewha Womans University, Seoul, Korea
6Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
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Corresponding author:
Hyesook Park,
Email: hpark@ewha.ac.kr
Abstract
OBJECTIVES
To efficiently utilize limited health and medical resources, it is necessary to accurately measure the level of health, which requires estimating the multimorbidity-corrected burden of disease.
METHODS
This study used 2015 and 2016 data from the National Health Insurance Service, and employed the list of diseases defined in a Korean study of the burden of disease, the criteria for prevalence, and the “cause–sequelae–health state” disease system. When calculating the years lost to disability (YLD), multimorbidity was corrected using Monte-Carlo simulation.
RESULTS
Correcting for multimorbidity changed YLD at all ages in Korea by -1.2% (95% confidence interval [CI], -24.1 to 3.6) in males and -12.4% (95% CI, -23.0 to 0.3) in females in 2015, and by -10.8% (95% CI, -24.1 to 4.6) in males and -11.1% (95% CI, -22.8 to 1.7) in females in 2016. The YLD rate for non-communicable diseases in males decreased more than that of other disease groups in both years, by -11.8% (95% CI, -19.5 to 3.6) and -11.5% (95% CI, -19.3 to -3.0), respectively. The overall YLD rate changed by -1.3% in the 5-year to 9-year age group, and the magnitude of this change remained similar until the 10-19-year age group, gradually decreased after 20 years of age, and steeply increased to more than 10% in those aged 60 and older.
CONCLUSIONS
Calculations of YLD should adjust for multimorbidity, as the disease burden can otherwise be overestimated for the elderly, who tend to exhibit a high prevalence of multimorbidity.
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