Disability-adjusted Life Years for 313 Diseases and Injuries: the 2012 Korean Burden of Disease Study

Abstract

This study is part of a 5-year research project on the national burden of diseases, injuries, and risk factors in Korea. Using disability-adjusted life years (DALYs), a metric introduced by the 1990 Global Burden of Disease (GBD) project, we performed a comprehensive and detailed assessment of the magnitude and distribution of both fatal and non-fatal health problems in the Korean population. The concept and general approach were consistent with the original GBD study, with some methodological modifications to make the study more suitable for Korea. We computed DALYs for 313 causes in both sexes and nine age groups using the entire population's medical records and newly generated Korean disability weights. In 2012, the dominant disease burden was non-communicable diseases, which accounted for 85.21% of total DALYs, while injuries accounted for 7.77% and communicable, maternal, neonatal, and nutritional disorders for 7.02%. Of the total DALYs, 88.67% were from years lived with disability and 11.32% were from years of life lost due to premature mortality. Diabetes mellitus was the leading cause of DALYs, followed by low back pain, chronic obstructive pulmonary disease, ischemic heart disease, ischemic stroke, cirrhosis of the liver, falls, osteoarthritis, motorized vehicle with three or more wheels, and self-harm. The results reported here identify key health challenges and opportunities for future health interventions and policy changes, and provide information that will help assess the major public health issues in Korea, a nation faced with one of the world's most rapidly ageing populations.

Quantifying Burden of Disease to Measure Population Health in Korea

“…The various KBD DALY measurement studies (1314151617181920212223242526272829303132333435) can be narrowed down to two major works supported by the Ministry of Health and Welfare. The first, KBD 2002, was a 4-year research project and involved the collaboration of five institutions (Seoul National University, the Korea Institute for Health and Social Affairs, Kyung Hee University, Sungkyunkwan University, and Hanyang University).…”

“…The second work, KBD 2012, is a recent 5-year project involving four collaborating institutions (Korea University, University of Ulsan, Ewha Womans University, and Kyung Hee University). Key findings from the first phase of the work have been published (29303132333435). The study covered 313 diseases and injuries for the reference year 2012, using improved methodology and an enhanced, higher-quality national database.…”

“…We adopted the GBD concepts but used Korean data sources that reflect the Korean health status and disease states. The current KBD methodology is described elsewhere (29303132333435). We used life expectancy tables produced by Statistics Korea, derived local disability weights, and applied time discounting and standard age weights to incidence-based YLLs and YLDs.…”

“…Our recent finding that non-fatal outcomes play a more important role than deaths in the nation’s disease burden (2930) highlights the usefulness of DALYs for describing the overall health status of a population (1345). Furthermore, NCD prevalence is expected to increase over the next decades (65) and concurrently, effective interventions and advances in medical technology are expected to allow those with NCDs to live longer in relatively good health.…”

“…The KBD project is working to address the study’s limitations and methodological problems to improve this accuracy (29). We hope to refine the methods and improve the validity of the DALY estimates so we can more precisely measure Korean population health (66).…”