Cost analysis of hypertension screening program (고혈압 건강진단의 비용분석)
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- Journal of Preventive Medicine and Public Health
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- v.22 no.3 s.27
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- pp.380-388
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- 1989
To evaluate the costs of the hypertension screening program of the Korea Medical Insurance Corporation, the records of the screening examinations were used. The sample size was 49,983 of the 906,554 people insured by the Corporation and was obtained by two-stage stratification random sampling. The alternatives for efficiency of the screening program, which were divided into three categories : modification of the screening test package, application of other hypertension diagnostic criteria, and selective approach of tested groups by age, were evaluated according to the cost per patient detected. The results of this study were as follows In the hypertension screening system, the cost per patient detected was Won 30,883. The most nonsensitive test for hypertension detection was ophthalmoscopy, which was examined during the second stage of screening. If the ophthalmoscope examination was excluded, olny one person was not detected, which was 0.2% of detected persons, and the cost per patient detected decreased to Won 28,098. The most efficient modification of the screening test package was measurement of blood pressure through the first and second stages of screening. The cost per patient detected by this modification was Won 24,408. The application of other diagnostic critera, which were more restricted criteria, increased the cost per patient detected by 3.7%-6.7%. The cost per patient detected were Won 170,582 for persons less than 39 years old, Won 20,032 for persons 40 to 59 years old, and Won 8,675 for persons 60 years old and over. In conclusion, the best alternative suggested with respect to efficiency and practical application excluded the ophthalmoscope examination of second stage screening and restricted the target population to persons greater than 40 years old. The application of this alternative decreased 54.9% of the screening costs and the cost per patient detected was Won 15,222. This study was limited in that measurement of effectivenes was not of the ultimate goal of screening, which is decreasing morbidity and mortality, but was of disease detection as the short-term objective.
Objectives : The aim of this study is to propose the W area of pulse (AW) as a new index which can confirm the arteriosclerosis by analyzing parameters of 5-level pressure pulse waveform measurement system for normotensive group according to aging. Methods : We measured radial pulse waveforms of normotensive group (20 to 60 years old) using 3-dimensional pulse imaging analyser (DMP-3000, DAEYOMEDI Co., Korea). And then we analyzed various parameters for sclerosis of the arteries such as Height (h1, h2, h3, h4, h5), Time (t1, t2, t3, t4, t5), AW, AW rate, Total area of pulse (At) and Augmentation Index (AIx). Results : As a result of analyzing parameters according to the aging, h2, h3, AS (systolic area rate to AT), AIx and AW were increased but t2/t, t3/t, t5/t and AD (diastolic area rate to AT) were decreased. Conclusions : We checked blood vessel conditions for normotensive group according to aging and confirmed various parameters. Also, we found that AW was analogous to AIx which has been used for diagnosing arteriosclerosis. Furthermore, we confirmed the usefulness of AW as a new parameter for checking vessel condition and characteristic compared with the AIx.
Recently, U-Healthcare is receiving attentions as a research for reducing the manpower, time in treatment, and etc. Although fundamental technologies, such as sensing, measuring, and etc. are sufficiently investigated. However, Technologies of IT/Medical convergence, which graft IT technologies to medical area, are still in germ. For this, we present a novel healthcare system, which can be applied to the middle sized medical environment, such as private hospital, home, or etc., by means of pre-verified technologies and the expert system. There exist IT element technologies are sufficiently developed in the fields, such as network, database or etc. due to the remarkable developments in IT technologies, and the healthcare is a mission-critical environment. Therefore, it is important not only to investigate novel approaches but also to utilize verified technologies for the U-Healthcare solution. Presented solution provisions automated medical services based on expert system by utilizing the measured data, such as body fat, blood pressure, blood glucose, and etc., in order to provide convenient treatment environment to doctors and nurses. In addition, since people, who do not have medical knowledge, can self-diagnose themselves, it is expected to cut medical costs in various areas. Especially, since each devices communicate with each other through standardized Bluetooth technology, Presented healthcare system is an extensible solution which can easily accept various medical devices. As a result of this, we can safely say that the self measurement and diagnosis services in U-Healthcare are now enhanced by reducing medical cost through our healthcare system.
The purpose of this study was to determine the effects of music therapy on changes in the vital signs of patients about to undergo an operation. The patients listened to the music at a time when they were feeling preoperative anxiety up until the preanesthesia was given in the operating room. The subjects for this study were selected from sixty patients to undergo operations, who were hospitalized at Dong Eui hospital in Pusan city. They were assigned to two groups, thirty to the experimental group and thirty to the control group. The subjects were from 20 years old to 69 years old, and had no other problem except the one requiring the operation, and no premedication. The data were collected during the period from July 1 to September 30, 1993. The method used in this study was to measure state-anxiety on the ward in the morning of the operation, and vital signs immediately before leaving for the operating room. Vital signs were measured immediately before the anesthesia was given and after the experimental group had listened to the music during the ten minutes needed to prepare the operation setting. The control group just waited during ten mimutes. Vital signs were check again before the anesthesia was given. The data were analyzed by descriptive statistics, mean±SD, p-value, and t-test using the SPSS progrom. The results of this study are : 1. Systolic blood pressure taken in the operating room was elevated, over the level measured on the ward, by 5.00 ± 15.26㎜Hg in experimental group and 18.67±14.56㎜Hg in control group. (t=-3.5496, p=.0008) 2. Diastolic blood pressure was elevated by 6.67±12.95㎜Hg in experimental group and 18.67±12. 79㎜Hg in control group. (t=-3.6100, p=.0006) 3. Pulse was elevated by 2.931±9.44 / min in experimental group and 8.03±8.37 /min in control group. (t=-2.2144, p=.0307) 4. Respiration was elevated by 0.60±1.35 /min in experimental group and 1.57±1.48 /min in control group. (t=-2.6409, p=.0106) 5. Body temperature was down by 0.13±1.91'c in experimental group and elevated by 1.13±1.11'c in control group. (t=-3.1471, p=.0026) Thus, in this study there was a statistically significant difference in the change in the vital signs between the experimental group treated with music therapy and the control group which received no treatment. Because music therapy is valuable to decrease the anxiety of patients facing operations, the result of this study support its effect in relieving anxiety as a valuable nursing intervention. From this study, the following recommendations can be made : First, it is necessary to further study music therapy to develope a better system and determine optimal time. Second, it is necessary that more detailed re-search on measurement of changes in vital signs be done to determine changes over time intervals.
The present study was conducted to investigate the possible role of the sympathetic nervous system in two-kidney, one clip (2K1C) and deoxycorticosterone acetate (DOCA)-salt hypertension. 2K1C and DOCA- salt hypertension were made in Sprague-Dawley rats. Four weeks after induction of hypertension, systolic blood pressure measured in conscious state was significantly higher in 2K1C
Background: It is insufficient information that are syndrome differentiations and detail symptoms in Korean. Methods: 19 traditional korean medical agencies collected 190 cases with vital sign, body measurement, patient own symptoms report and doctor diagnosis. And then we analyzed general distributions and comparisons of deficiency and non-deficiency. Results: The most past histories, in order, were the arthritis(20%), gastroenteropathy, hypertension, anemia, diabete mellitus. In chief complains, musculoskeletal occupies 60 percent of the total, and digestive system, head in order. In the syndrome differentiation, it appeared deficiency, spleen, Qi deficiency in order. Age(p=0.000), systolic blood pressure(p=0.044) and the waist-hip ratio(p=0.000) was significantly higher in the deficiency group compared with non-deficiency group. Patients with condition which dislikes the wind and with anxiety and with amazing and fear(驚恐) were significantly more in deficiency group(p=0.029, p=0.017, p=0.044). Conclusions: These statistics are continually revised report and it will be reported comparison of several syndrome differentiations and therapeutic effects by treatment methods.
Physiological signals such as body temperature, heart rate, blood pressure and heart rate variability and biomechanical workload for stress analysis were investigated during the cherry tomato harvesting work in a greenhouse. The skin temperatures raised
Recently in HCI research, emotion recognition is one of the core processes to implement emotional intelligence. There are many studies using bio signals in order to recognize human emotions, but it has been done merely for the basic emotions and very few exists for the other emotions. The purpose of present study is to confirm the difference of autonomic nervous system (ANS) response in three emotions (boredom, pain, and surprise). There were totally 217 of participants (male 96, female 121), we presented audio-visual stimulus to induce boredom and surprise, and pressure by using the sphygmomanometer for pain. During presented emotional stimuli, we measured electrodermal activity (EDA), skin temperature (SKT), electrocardiac activity (ECG) and photoplethysmography (PPG), besides; we required them to classify their present emotion and its intensity according to the emotion assessment scale. As the results of emotional stimulus evaluation, emotional stimulus which we used was shown to mean 92.5% of relevance and 5.43 of efficiency; this inferred that each emotional stimulus caused its own emotion quite effectively. When we analyzed the results of the ANS response which had been measured, we ascertained the significant difference between the baseline and emotional state on skin conductance response, SKT, heart rate, low frequency and blood volume pulse amplitude. In addition, the ANS response caused by each emotion had significant differences among the emotions. These results can probably be able to use to extend the emotion theory and develop the algorithm in recognition of three kinds of emotions (boredom, surprise, and pain) by response measurement indicators and be used to make applications for differentiating various human emotions in computer system.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70