The Gaps in Health-Adjusted Life Years (HALE) by Income and Region in Korea: A National Representative Bigdata Analysis

Abstract

Abstract Background This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability from the national claims data and aims to identify the differences and inequalities in income level and region. Methods The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based years lived with disability (YLD) for 260 disease groups, and this was used 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 administrative districts to cover the whole country. Results The primary outcome was HALE in the Korean population. The second outcome was the HALE’s gap in terms of income and region. HALE increased from 2008 to 2016. Results by gender suggest that HALE in males increases faster than in females. Results by income level show that HALE is higher in higher income level. In 2016, the gap in HALE between Q1 and Q2, the lower income group, was about 5.10 years. The gap in females by income level was smaller than that in males, which can be because males have greater inequality in terms of HALE by income level. Moreover, the gap in HALE by region was found to increase. Conclusions Results suggest that there is an inequality in years of living with disability in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.

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