• Title/Summary/Keyword: 고혈압 의료비

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Relationship between Oral Health Care Behaviors and Perceived Periodontal Disease on Hypertension Patients (고혈압 환자의 구강건강관리 행태와 주관적 치주건강수준의 상관관계 연구)

  • An, Eunsuk;Kim, Min-Young
    • Journal of dental hygiene science
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    • v.16 no.1
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    • pp.101-109
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    • 2016
  • The purpose of this study was to examine the impact of the oral health behaviors and lifestyle of hypertension patients on their perceived periodontal diseases. The data of the 2013 community health survey were used, and the data of 55,632 patients who suffered from hypertension and who were at the ages of 19 and over was analyzed. The analying methods used in this study were chi-square test and multiple logistic regression analysis. Gender, age, marital status, education, economic activity, income level and subscription to private medical insurance were identified as the factors to affect the perceived periodontal disease of the hypertension patients, and lifestyle and oral health behaviors were found to have exerted a significant influence on perceived periodontal disease. As this study found that not only the socioeconomic characteristics of the hypertension patients but their oral health care and lifestyle were all correlated with perceived periodontal disease, how to promote the oral health of those who are susceptible to periodontal diseases should carefully be considered.

An Analysis on the Difference of Influential Factors between Metabolic Syndrome Group and Attention Group (대사증후군과 주의군 간의 영향요인 차이 분석)

  • Lee, Hyun-Ju
    • The Journal of Korean Society for School & Community Health Education
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    • v.23 no.2
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    • pp.25-38
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    • 2022
  • 목적: 본 연구의 목적은 대사증후군 주의군 대비 대사증후군의 위험요소를 식별하여 예방을 위한 중재방안을 마련하기 위한 것이다. 방법: 한국의료패널 2015년도 데이터를 활용하여 당뇨만 앓고 있는 사람을 주의군으로 당뇨, 고혈압, 이상지질혈증을 모두 앓고 있는 사람을 대사증후군으로 구분하여 추출한 다음 가중치를 부여하여 총 1,559,884명을 대상으로 하였다. 주의군 대비 개인적 특성, 건강생활습관 특성, 삶의 질 특성, 의료이용 특성에 대한 대사증후군의 영향요인을 분석하였다. 결과: 개인적 특성에서는 40대미만 연령대에 비해 연령에 비례하여 대사증후군 위험이 증가하다 70대에 40대미만과 유사한 수준으로 떨어졌다. 남성보다는 여성, 고졸이하보다는 대졸이상, 중소지역에 비해 서울시 거주자, 장애가 없는 군보다는 있는 군, 의료급여가입자보다는 건강보험 가입자, 경제활동을 안하는 군보다는 경제활동 군의 대사증후군 위험이 높았다. 건강생활 습관 특성에서는 비흡연자보다는 흡연자, 술을 안마시는 군보다는 주 2-3회 이상 음주자, 운동을 하는 군보다 안하는 군, BMI가 정상인 군보다는 30 이상인 군에서 대사증후군 위험이 높았다. 삶의 질 특성에서는 일상 활동에 지장이 없는 군보다 있는 군, 통증이나 불편이 없는 군보다 있는 군, 주관적 건강상태가 보통이상보다는 나쁜 군, 섭식문제가 없는 군보다 있었던 군에서 대사증후군 위험이 높았다. 의료이용 특성에서는 미충족 의료이용 경험이 없는 군보다 있었던 군, 약제비가 부담이 안되는 군보다 부담이 되는 군에서 대사증후군 위험이 높았다. 결론: 당뇨를 앓고 있는 그룹 중 본 연구를 통해 확인된 대사증후군 위험 요소가 많은 이들에 대해 우선적으로 대사증후군 예방 보건교육을 집중하는 방안을 제언한다.

A Mechanism how Obesity to Attain A Status of Disease (비만의 질병지위 획득 메커니즘)

  • Park, Hye Kyung
    • Journal of Science and Technology Studies
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    • v.14 no.2
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    • pp.165-198
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    • 2014
  • This study investigated a mechanism of naming a disease, as examining how obesity attain a status of disease. WHO(World Health Organization) warned 'The obesity is definitely a disease to need medical treatment' in 1996 and 1997. However, before then, obesity was classified as unusual or nonstandard body status but it was not categorized as a disease. In order to examine a mechanism how obesity attain the status of disease, this study examined the historical process of construction to obesity in discourse of disease and ontological reality of pathological epidemiological to obesity. As a result of this research, it was found that the medical community manipulated BMI(Body Mass Index) and deliberately narrowed the range of person's normal weight, and institutionalized sizism. Especially, it was found that as the medical community associated the body state of obesity with high blood pressure, diabetes, and etc that causes burden of medical expenses to patients, that was fatphobia. And it tried to from a medical control mechanism to assign obesity to an independent status of a disease. Based on this examination, this study found an entailment: the noninfectious disease such as obesity attains the status of disease not because of the pathologic reason but because of cultural or socio-economical reason which han nothing to do with any medical source.

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Utilization and Expenditure of Health Care and Long-term Care at the End of Life: Evidence from Korea (장기요양 인정자의 사망 전 의료 및 요양서비스 이용 양상 분석)

  • Han, Eun-jeong;Hwang, RahIl;Lee, Jung-suk
    • 한국사회정책
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    • v.25 no.1
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    • pp.99-123
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    • 2018
  • Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

일본에서의 건강증진사업의 노력과 성과 : 건강일본 21의 중간평가

  • O, Eun-Hwan
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2009.05a
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    • pp.108-108
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    • 2009
  • 일본에서는 일차보건의료의 중요성을 강조하고 건강증진 향상을 위한 노력의 일환으로 제기된 알마아타선언이 발표된 1978년과 때를 같이 하여 같은 해부터 국민건강 만들기 대책이 시작되어 지금까지 30여년의 시간이 지났다. 그 동안 두 차례의 정책수정 과정을 거쳐, 2000년부터는 제3차 건강만들기의 활동으로 "건강일본 21"을 실시하고 있다. 건강일본 21의 기본적인 목적은 모든 국민이 건강하고, 활기가 넘치는 사회를 실현하며, 조기사망을 예방하고 치매와 같은 병상상태의 생활에서 벗어나 건강수명을 연장하는 것으로 하고 있다. 이를 위하여 조기사망이나 장애와 관련된 암, 뇌졸중, 심장질환, 자살 등과 같은 질환군을 파악하고, 이러한 질환군에 영향을 미치는 비만, 고혈압, 당뇨, 치주질환 등에 관한 위험군을 찾아내어, 이러한 것들을 사전에 예방할 수 있도록 하는 흡연, 음주, 식사, 운동과 같은 생활습관과 관련된 요인들을 개선하도록 하는 노력을 기울이고 있다. 이에 본 연구에서는 건강일본 21에서 사업영역으로 정한 (1) 영양 및 식생활, (2) 신체활동 및 운동, (3) 휴양 및 마음의 건강 만들기, (4) 흡연, (5) 음주, (6) 치아건강, (7) 당뇨병, (8) 순환기질환, (9) 암 등에 관한 각 분야에 있어서 현재의 현황을 알아보고, 지금까지의 성과를 파악하며 앞으로의 현실가능성을 전망해 보았다.

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An System for Efficient Management of Genomic Epidemiological Cohort Study Information from Koreans (한국인 유전체 역학 정보의 효율적 관리를 위한 정보 관리 시스템)

  • 양은주;안윤진;이지은;김규찬
    • Proceedings of the Korean Information Science Society Conference
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    • 2003.04a
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    • pp.635-637
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    • 2003
  • 본 논문에서는 경기도 안성과 안산 지역에 설치된 유전체역학센터에서 조사 지역에 거주하는 45세 이상 69세 이하의 성인을 대상으로 고혈압, 당뇨, 골다공증, 천식, 비만 등 총국민의료비용에서 큰 부분을 차지하는 4-5개의 중요 만성질환을 주요 분석 분야로 진행중에 있는 한국인 유전체 역학조사사업으로부터 산출되는 임상검사 및 역학정보를 입력.관리하는 시스템에 대해 소개하고 있다. 검진 대상자를 접수하는 접수자 및 정보 관리자는 본 시스템을 통해 검진 대상자의 개인식별 정보, 생활습관 정보 등과 같은 설문 정보와 임상 검사 정보를 입력 후 이에 대한 조회, 관리, 집계 현황 출력, 데이터 백업 등을 수행할 수 있다.

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A Novel Method of Measuring the state of Kidney by Analysing the Color and Gloss of the Patient's Face (안면 색윤(色潤) 분석을 통한 신장 기능 측정 방법 제안)

  • Lee, Se-Hwan;Cho, Dong-Uk;Kang, Eung-Taek
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.35 no.7C
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    • pp.634-641
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    • 2010
  • End Stage Renal Disease resulting from complications of the 4 top causes of death including diabetes and hyperpiesia becomes one of the major social problems these days in the context that this disease unaffordably increases the medical cost and decreases the quality of life. For a kidney disease, it is hard to diagnose, cure and recover as there are few subjective symptoms. Therefore, the prevention is very important. In this paper, we propose a method, which checks the abnormal state of the kidney, using the patient's face color and gloss which is employed for diagnosis in the oriental medicine. This method composes of two processes. The first is to acquire the patient's face data applying a polarizing filter and the next is to analyse relations between kidney disease and this data.

Influence of Usual Source of Care on Outpatient Visit and Expense of Hypertension Patients (상용치료원 보유여부가 고혈압 환자의 외래이용횟수 및 외래의료비에 미치는 영향)

  • Yoon, Hyo Jung;Choi, Jae Woo;Lee, Sang Ah;Park, Eun-Cheol
    • Korea Journal of Hospital Management
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    • v.22 no.1
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    • pp.1-9
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    • 2017
  • Purpose : Many studies showed that having a usual source of care improved the efficient access of healthcare service. However in Korea there have been few studies on the usual source of care. So this study aims to find whether having a usual source of care affect the medical utilization and expense. Methodology/Approach : We used the Korean Health Panel data in 2012, 2013 to examine the change of utilization and expenses in ambulatory care affected by having a usual source of care. We selected 1,215 hypertension patients without usual source of care in 2012 and performed linear regression analysis to identify the difference between treatment group(with usual source of care in 2013) and control group(without usual source of care in 2013). Then we performed analysis again separated by the age group. Findings : Among study population, 711(58.5%) reported that they have a usual source of care in 2013. Treatment group reported 1.85 less increase in outpatient visits and 69,234 won less increase in expense than control group with weak significance(visit ${\beta}$ -1.85 p-value 0.0807, expense ${\beta}$ -69,234 p-value 0.0541). People under the age of 65 showed significant change in outpatient visits for tertiary hospital (visit ${\beta}$ -0.78 p-value 0.0154, expense ${\beta}$ -91,462 p-value 0.0168). The analysis which focused outpatient for mild disease showed similar trend. Practical Implications : This study supports the positive effect of having usual source of care which decrease inefficient outpatient utilization. Promoting physician-patient relationships is important for efficiency of healthcare service.

A study on the development of severity-adjusted mortality prediction model for discharged patient with acute stroke using machine learning (머신러닝을 이용한 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발에 관한 연구)

  • Baek, Seol-Kyung;Park, Jong-Ho;Kang, Sung-Hong;Park, Hye-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.126-136
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    • 2018
  • The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

Dehydration Risk from Age, BMI, and Disease Exposure (연령, BMI, 질병노출로 인한 탈수 위험)

  • Kim, Sun-Hee;Chun, Sung-Soo;Choi, Myung-Sup;Yun, Mi-Eun
    • Korean Public Health Research
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    • v.44 no.4
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    • pp.35-49
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    • 2018
  • Objective : The purpose of this study was to investigate the risk factors of dehydration from the subjects who underwent anthropometric and blood parameters testing during a comprehensive health screening. Methods : For the study analysis, 5,391 samples with valid data of the levels of Sodium($Na^+$), BUN (Blood Urea Nitrogen) and FBS(Fasting Blood Sugar) were selected to calculate a dehydration indicator of plasma osmolality. The study data was collected from the health screening examinees who visited Sahmyook Medical Center Seoul Adventist Hospital Comprehensive Health Check-up Center from 2014.01.01 to 2015.12.31. The relationship between dehydration and age group, BMI, disease exposures(hypertension, diabetes mellitus, dyslipidemia, kidney disorder) were analyzed by gender. Results : The odds ratio of dehydration showed statistical significance from age ${\geq}50$ in both male and female, respectively. The female obese group was vulnerable to dehydration while the male study group showed no statistical significance in the BMI difference. The disease exposed groups(hypertension, diabetes mellitus, dyslipidemia, kidney disorder) were vulnerable to dehydration. Also, the more types of disease carried by the exposed patients, the higher odds ratio and susceptibility to dehydration. Conclusions : Aging, increasing BMI, and exposed to diseases were found to be the risk factors for vulnerability to dehydration. To prevent dehydration, special caution to be taken for those in the ${\geq}50s$ group, along with controlling BMI and chronic diseases. Further studies are suggested to investigate the risk factors of dehydration that may affect increasing plasma osmolality as a potential stimulus mechanism in disease outbreaks.