• The Korean Journal of Applied Statistics
• /
• v.21 no.4
• /
• pp.639-647
• /
• 2008

This study used the characteristics of the knowledge discovery and data mining algorithms to develop tailored hypertension follow up management model - hypertension care predictive model and hypertension care compliance segmentation model - for hypertension management using the Korea National Health Insurance Corporation database(the insureds’ screening and health care benefit data). This study validated the predictive power of data mining algorithms by comparing the performance of logistic regression, decision tree, and ensemble technique. On the basis of internal and external validation, it was found that the model performance of logistic regression method was the best among the above three techniques on hypertension care predictive model and hypertension care compliance segmentation model was developed by Decision tree analysis. This study produced several factors affecting the outbreak of hypertension using screening. It is considered to be a contributing factor towards the nation’s building of a Hypertension follow up Management System in the near future by bringing forth representative results on the rise and care of hypertension.

• Journal of Digital Convergence
• /
• v.11 no.9
• /
• pp.255-265
• /
• 2013

The purpose of this study was to identify the variation factors of hypertension medication rate between regions and to use them as a basic data for establishment of hypertension management business plan which is customized by region. The data were collected from community health survey, National Statistics Office and National Health Insurance Corporation, and were analyzed using the geographically weighted regression. As the result of analysis, the factors that influenced the hypertension medication rate between regions were subjective recognition rate of health level, the rate of medical aid client and the number of health facility per one hundred thousand of population. According to the geographically weighted regression, the total of 230 regional regression models composed of major variables which affected the hypertension medication rate were calculated. However, this study has several limitations that the explanatory power of model is not high and others. Therefore, a follow-up study which is based on the actual data of compliance with hypertension medication will be necessary.

• Health Policy and Management
• /
• v.23 no.4
• /
• pp.427-433
• /
• 2013

Background: This study was conducted to evaluate the factors affecting adherence in patients with hypertension and type 2 diabetes mellitus before and after a clinic based patient incentive program in Incheon. Methods: An observational follow-up study was done for 28,355 patients in one registered group and 245,598 patients in a non-registered group from March 16th 2009 to December 31th 2010 in Incheon. The registration, mandatory laboratory tests and number of clinic visits were collected by merging the Incheon Chronic Disease Management System data and the National Health Insurance Corporation (NHIC) data. As a measure of patient adherence, we used a variable of prescription days from the NHIC and defined above 80% of average prescription days as an appropriate patient adherence. Repeated measures analysis of variance and logistic regression were used to analyze the differences in patient adherence and factors affecting adherence. Results: The changes in prescription days for the registered group are larger than for the non-registered group. In the logistic regression model, including the variables with sex, age, income status and number of clinic visits, the registered group exhibited a higher Odds ratio in the patient adherence. Conclusion: This study revealed the association between registration and appropriate patient adherence in patients with hypertension or type 2 diabetes mellitus.

• Journal of Preventive Medicine and Public Health
• /
• v.32 no.4
• /
• pp.435-442
• /
• 1999

Objectives: The purpose of this study was to examine the twelve-year incidence of hypertension, and to find risk factors for the incidence in adult population in Kangwha County, Korea. Methods: In 1986, 413 males(mean age 37 years) and 434 females(mean age 33 years) were examined in the Kangwha Study, Among 764 non-hypertensive participants, 164 males and 214 females were reexamined in 1998. Blood pressure(BP) was measured with standard mercury sphygmomanometers. Multiple logistic regression analysis was used to estimate the relative risk of risk factors on the incidence of hypertension. Results: During the 12-year period, 68 of 164 males and 53 of 2f4 females developed hypertension. In a multiple logistic model adjusted for age and pulse rate, baseline BP, baseline body mass index(BMI) and BMI change during the follow-up period were significantly related to the incidence of hyperiension. Adjusted relative risk(RR)s of baseline high-normal BP were 3.90(95% CI: 1.81-7.84) in males, and 12.72(95% CI: 3.70-30.73) in females. Compared with lower baseline BMI group, adjusted RRs of middle baseline BMI group were 2.66(95% CI: 1.19-5.70) in males, and 2.33(95% CI: 0.95-5.55) in females. Adjusted RRs of upper baseline BMI group were 3.52(95% CI: 1.53-7.67) in males and 3.63(95% CI: 1.50-8.43) in females. Increase of BMI was positively related to the incidence in males(adjusted RR=2.71, 95% CI: 1.00-6.71) and females(adjusted RR=3.05, 95% CI: 1.29-6.88). Conclusions: The twelve-year incidence of hypertension was 41.5% in males, and 25.8% in females. Baseline BP, baseline BMI, and BMI change were strongly related to the incidence of hypertension.

• The Korean Journal of Pain
• /
• v.36 no.2
• /
• pp.184-194
• /
• 2023

Background: Degenerative lumbar spondylolisthesis (DLS) is frequently associated with lumbar spinal stenosis (LSS) and conservative treatments such as epidural steroid injection do not have long-term benefits in LSS patients with DLS. This study evaluated the effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with LSS and DLS. Methods: Patients' sex, age, body mass index, diabetes, hypertension, stenosis grading, pain duration, location, pain intensity, and medications were retrieved from electronic medical records. At 1, 3, and 6 months following the procedure, data on pain severity, medication usage, and physical functional status were analyzed. A generalized estimating equations model was used at the six-month follow-up. Patients were divided into those with DLS (the spondylolisthesis group) and those without DLS (the no spondylolisthesis group) to evaluate whether the effects of percutaneous epidural neuroplasty using a balloon catheter were different. Results: A total of 826 patients were included (spondylolisthesis: 433 patients, 52.4%; no spondylolisthesis: 393 patients, 47.6%). Age, body mass index, hypertension, pain location, and stenosis grading were statistically different between the two groups. The generalized estimating equations analyses with unadjusted and adjusted estimation revealed a significant improvement in the estimated mean numerical rating scale of pain intensities compared to that at baseline in both groups (P < 0.001). Any adverse events that occurred were minor and temporary. Conclusions: Percutaneous epidural neuroplasty using a balloon catheter may be an alternative treatment option for patients with chronic LSS, regardless of accompanying DLS, who have had failed conservative management.

• Health Policy and Management
• /
• v.22 no.2
• /
• pp.263-274
• /
• 2012

This study describes the hypertensive patients characteristics associated with the health incentive point program, and develops and analyzes a simple predictive model of participation in the program. Based on the Incheon Chronic Disease Management System(iCDMS), a model program of community partnership for hypertensive or diabetic patients detection and follow-up since 2005 in Incheon metropolitan city, a cross-sectional design was used in this study. An effective 10.844 adults sample was divided into groups according to participation in the health incentive point program and continuing treatment, and individual and health characteristics among groups were compared. Furthermore, the predictors associated with participation in the program were identified by the logistic regression analysis. After the health incentive point program in iCDMS was introduced, the number of hypertensive patients participation in the program increased 23.9 times which is vastly high given the various programs were provided. There were statistically significant differences among the groups: age(p=0.000), treatment compliance(p=0.000), and blood pressure control at the last measurement(p=0.000), in particular, between participation group(GroupI, n=246) and non-participation group(GroupIII, n=10,408). Furthermore, age over 60 years(OR: 0.33), treatment compliance(OR: 3.49~3.78) and blood pressure controls(OR: 2.13~2.30) were statistically significant predictors associated with participation in the program, based on the logistic regression analysis with GroupI and GroupIII. To increase participation in the health incentive point program, variables such as age, treatment compliance and blood pressure controls are more concerned. And, high-risk patients and family members need targeted health incentive programs.

• Journal of agricultural medicine and community health
• /
• v.37 no.3
• /
• pp.167-180
• /
• 2012

Objective: This study was conducted to evaluate an education program for cardiocerebrovascular high-risk patients. Methods: This program was developed according to Tyler's model for curriculum development. To evaluate the effects of this program, we measured clinical outcome change (weight, waist circumference, systolic blood pressure, diastolic blood pressure) and behavior change stages (checking blood pressure, blood sugar levels, doing physical activity, consistent maintenance of food intake, eating low amounts of salt, abstention from tobacco and alcohol) before and 4 weeks after participation in the education program. The group of subjects consisted of High-risk group patients who attended basic program(32 patients), and staged program(37 patients) during KHyDDI meetings from Oct. 2009 to May 2010. Results: The staged educational program was developed three aspects(disease, nutrition and exercise)and three stages(basic, in-depth and individual education). In the staged education program, the evaluations were made by measuring clinical outcome and stage of behavior before and after education. Significant differences were found in waist circumference, systolic blood pressure, diastolic blood pressure, consistent maintenance of food intake(p<0.05), and eating low salt(p<0.001)and their self efficacy. Conclusion: In the practice-oriented staged education program, significant differences were found in the clinical outcomes and stage of behavior before and after education. Possible limitations of the study include the small number of participating subjects and the short follow-up management period, but the results indicate that continued application of this program could contribute to the prevention of cardiocerebrovascular diseases for the elderly patients with long periods of chronic diseases.

• Childhood Kidney Diseases
• /
• v.10 no.1
• /
• pp.27-32
• /
• 2006

Purpose : Conservative management of multicystic dysplastic kidney(MCDK) without nephrectomy has recently been advocated. The purpose of this study was to determine the clinical course of conservatively managed MCDK and to find out possible predictive factors for involution of MCDK by ultrasonography(US). Methods : A retrospective analysis was made on 45 patients(26 boys and 20 girls) in whom MCDK was detected and had been traced by US between Dec. 1993 and Aug. 2005 at Severance Hospital. Results : Median follow-up time was 30 months(range 2-102 months). All patients under-went radionuclide scans and voiding eystourethrograms. The serial follow-up US showed complete involution in 11(24%), partial involution in 19(41%), and no interval change or increased in cyst size in 13(28%) patients. Nephrectomy was done in 3 patients(7%) due to relapsing urinary tract infection(UTI) and severe abdominal distension. The mean age of complete involution of MCDK was 37 months(range 12-84 months). Episodes of UTI were present in 17 patients(37%) and additional genitourinary(GU) abnormalities were found in 22 patients(44%). Hypertension and renal insufficiency was complicated in one patient. No child developed malignant tumor. Univariate analysis showed that five variables were associated with complete involution of the MCDK; gender, site, UTI episode, additional GU abnormalities, and renal length on initial US. After adjusting using the Pearson model, the presence of additional GU abnormalities was exclusively associated with complete involution among the 5 variables(P=0.034). Conclusion : In our review of 46 cases of MCDK, non-surgical approach for patients with MCDK was advisable and we could predict poor prognosis when MCDK is associated with other GU anomalies.