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Comparing Korea Occupational Safety & Health Agency and National Health Insurance Service's cardio-cerebrovascular
Yunrae Cho1, Dong Geon Kim1, Byung-Chan Park1
1Department of Occupational and Environmental Medicine, Dongguk University Gyeongju Hospital, Gyeongju, Korea.
Insights
The Korea Occupational Safety & Health Agency (KOSHA) and National Health Insurance Service (NHIS) cardio-cerebrovascular disease (CVD) risk assessment tools show moderate correlation and fair agreement. NHIS tends to classify individuals into higher risk categories than KOSHA.
Area of Science:
- Public Health
- Cardiology
- Occupational Health
Background:
- Cardio-cerebrovascular diseases (CVDs) are a leading global cause of mortality.
- South Korea utilizes CVD risk assessment tools from KOSHA and NHIS.
- The NHIS tool is an approved alternative to the KOSHA tool for worker CVD risk evaluation since 2018.
Purpose of the Study:
- To evaluate the correlation and agreement between KOSHA and NHIS CVD risk assessment tools.
- To compare the classification of CVD risk levels between the two assessment tools.
Main Methods:
- Analysis of 17,485 individuals aged 20-64 undergoing medical examinations.
- Classification into low, moderate, high, and highest risk groups using both KOSHA and NHIS tools.
- Statistical comparison using cross-analysis, Spearman correlation, and kappa coefficient.
Main Results:
- A statistically significant correlation (p < 0.001) was found between KOSHA and NHIS tools (correlation coefficient = 0.403).
- A fair agreement was observed (kappa coefficient = 0.203).
- Concordance in risk classification was seen in 37.1% of participants; KOSHA classified 56.7% into lower risk and 6.2% into higher risk compared to NHIS.
Conclusions:
- The KOSHA and NHIS CVD risk assessment tools demonstrate moderate correlation and fair agreement.
- The NHIS tool tends to categorize individuals into higher CVD risk groups compared to the KOSHA tool.
- Selecting a more sensitive CVD risk assessment tool and implementing early interventions for high-risk individuals is recommended for effective prevention.
Background:
Cardio-cerebrovascular diseases (CVDs) are the most common cause of death worldwide. Various CVD risk assessment tools have been developed. In South Korea, the Korea Occupational Safety & Health Agency (KOSHA) and the National Health Insurance Service (NHIS) have provided CVD risk assessments with health checkups. Since 2018, the KOSHA guide has stated that NHIS CVD risk assessment tool could be used as an alternative of KOSHA assessment tool for evaluating CVD risk of workers. The objective of this study was to determine the correlation and agreement between the KOSHA and the NHIS CVD risk assessment tools.
Methods:
Subjects of this study were 17,485 examinees aged 20 to 64 years who had undergone medical examinations from January 2021 to December 2021 at a general hospital. We classified subjects into low-risk, moderate-risk, high-risk, and highest-risk groups according to KOSHA and NHIS's CVD risk assessment tools. We then compared them with cross-analysis, Spearman correlation analysis, and linearly weighted kappa coefficient.
Results:
The correlation between KOSHA and NHIS tools was statistically significant (p-value < 0.001), with a correlation coefficient of 0.403 and a kappa coefficient of 0.203. When we compared risk group distribution using KOSHA and NHIS tools, CVD risk of 6,498 (37.1%) participants showed a concordance. Compared to the NHIS tool, the KOSHA tool classified 9,908 (56.7%) participants into a lower risk category and 1,079 (6.2%) participants into a higher risk category.
Conclusions:
In this study, KOSHA and NHIS tools showed a moderate correlation with a fair agreement. The NHIS tool showed a tendency to classify participants to higher CVD risk group than the KOSHA tool. To prevent CVD more effectively, a higher estimation tool among verified CVD risk assessment methods should be selected and managements such as early intervention and treatment of risk factors should be performed targeting the high-risk group.
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