[Assessment of applicability of standardized rates for health state comparison among areas: 2008 Community Health Survey].
OBJECTIVE
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.
Kwon
Geun-Yong
GY
School of Public Health, Seoul National University, Korea.
Lim
Do-Sang
DS
Park
Eun-Ja
EJ
Jung
Ji-Sun
JS
Kang
Ki-Won
KW
Kim
Yun-A
YA
Kim
Ho
H
Cho
Sung-Il
SI
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D056910:Republic of Korea / Q000453:epidemiology; D017062:Small-Area Analysis; D055815:Young Adult