• Health Policy and Management
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• v.31 no.1
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• pp.65-73
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• 2021

Background: With the recent aging of the population, the transition to a disease structure centered on chronic diseases is accelerating. Moreover, the socio-economic gap and the polarization of the health gap between regions further increase the burden of disease on the country. Accordingly, this study calculated the disease cost of hypertension, diabetes, and hyperlipidemia, which are the three major chronic diseases, to establish an effective health promotion policy strategy for each region, and analyzed the gap in disease cost within the region to determine health determinants at the individual as well as the regional level. Methods: This study utilized data from the 2015 sample cohort of the National Health Insurance Service and calculated the disease cost of patients (diabetes: I10-I15, hypertension: E10-E14, hyperlipidemia: E78) based on the main diagnosis. Results: Based on our analysis, the case of medical use in cities and provinces was higher than in metropolitan cities, with relatively small medical use in Seoul and Gangwon-do. In terms of the disease cost, the cost of chronic diseases in Seoul and Jeju was the highest, but the difference in disease cost between patients in each region was the largest in Seoul and Gangwon-do. Conclusion: The results of this study provide meaningful data for implementing efficient health promotion policies by analyzing the differences in disease cost and identifying health determinants in different regions. Furthermore, in Korea, where socioeconomic differences are clearly revealed, it can be used as a basis for preparing a strategic plan, from a long-term perspective, to improve the health of patients with chronic diseases in the future.

• Journal of the Korea Convergence Society
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• v.8 no.10
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• pp.273-279
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• 2017

Purpose: This study was conducted to identify factors associated with cataract and age-related macular degeneration in elders. Methods: In total, 341,588 men(44.18%,) and women(61.887%), aged over 60, were recruited from Korean National Health Insurance Service-Senior(2002-2013). We also analysed the factors which determine the prevalence of contract (ICD-10: H25) and age-related macular degeneration(ICD-10: H353) using Cox proportional hazard regression model Results: The subjects who were women, in older age, the group of higher income level, with hypertension, with heart disease, and with diabetes, the prevalence of both contract and age-related macular were increased(p<0.0001). Conclusion: The prevalence of contract and age-related macular degeneration were higher in old age of Korean who has chronic diseases such as hypertension, heart disease, and diabetes. The management of chronic diseases are essentially required in elderly for more healthy eye in aged society.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.245-253
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• 2016

Objective: This study was conducted to evaluate payer-driven medication adherence intervention program from the patient's and counselor's perspectives. Methods: Target patients for intervention were selected by retrospective adherence measures based on national health insurance claims data for hypertension, diabetes and hyperlipidemia. As a serial intervention for higher risk groups of medication non-adherence, initial direct mailing, the first direct telephone call and the second direct call or a home visit were followed. Interview approach to qualitative inquiry was used to evaluate intervention results. Results: Participants including 4 patients received telephone calls, and 4 National Health Insurance Service staff and 4 pharmacists participated as counselors were interviewed regarding their impression of the intervention program. Three major themes arose: overall perception; necessities; and suggestions for success, of the intervention. Despite short period of intervention, educational intervention by telephone counseling involving pharmacists shows potential to improve self-management of chronic disease, and pharmacist-involvement. But more sophisticated selection of target patients requiring the intervention and complementation of electronic database system would be necessary. In addition, personal disposition of counselor was revealed to be an important factor for achieving successful outcome of intervention. Conclusion: The findings suggest that the individualized counseling intervention would be an efficient option for improved medication adherence. Further researches should include longer periods of interventions, a quantitative analysis using adherence measures based on claims data and consideration of clinical benefits associated with the intervention.

• Genomics & Informatics
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• v.12 no.4
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• pp.181-186
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• 2014

Genome-wide association studies have proven the highly polygenic architecture of complex diseases or traits; therefore, single-locus-based methods are usually unable to detect all involved loci, especially when individual loci exert small effects. Moreover, the majority of associated single-nucleotide polymorphisms resides in non-coding regions, making it difficult to understand their phenotypic contribution. In this work, we studied epistatic interactions associated with three common diseases using Korea Association Resource (KARE) data: type 2 diabetes mellitus (DM), hypertension (HT), and coronary artery disease (CAD). We showed that epistatic single-nucleotide polymorphisms (SNPs) were enriched in enhancers, as well as in DNase I footprints (the Encyclopedia of DNA Elements [ENCODE] Project Consortium 2012), which suggested that the disruption of the regulatory regions where transcription factors bind may be involved in the disease mechanism. Accordingly, to identify the genes affected by the SNPs, we employed whole-genome multiple-cell-type enhancer data which discovered using DNase I profiles and Cap Analysis Gene Expression (CAGE). Assigned genes were significantly enriched in known disease associated gene sets, which were explored based on the literature, suggesting that this approach is useful for detecting relevant affected genes. In our knowledge-based epistatic network, the three diseases share many associated genes and are also closely related with each other through many epistatic interactions. These findings elucidate the genetic basis of the close relationship between DM, HT, and CAD.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.2
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• pp.234-240
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• 2012

The purpose of this case-control study is to investigate the relationship between storke and stroke risk factors, such as family history and past history. The case-control study over clinical data registered from Daejeon Oriental Medical Hospital in the period of November 2006 to July 2010. Study subjects consisted of 108 patients with acute stroke within 1 month as the case group (Cases) and 108 people who visited hospital for health care as the genreral control group (Controls). The participants had been interviewed by residents to find out their family history and past history. Their blood was taken to check the blood lipid level and liver function. 1. The people whose family history included cerebrovascular accident had more probability of stroke than the people who did not have cerebral vascular accident as their family history. 2. The people who suffered from hypertension had more probability of stroke than the people who did not suffer from hypertension. 3. The people who suffered from diabetes mellitus had more probability of stroke than the people who did not suffer from diabetes mellitus. Based on this study, the people who had cerebral vascular accident as their family history should thoroughly treat their blood pressure and blood sugar level to prevent the cerebral vascular accident.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2595-2598
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• 2013

Background: Prostate cancer is common in elderly men, especially in western countries, and incidences are rising in low-risk populations as well. In India, the age-standardized rates vary between registries. Under these circumstances we have estimated the survival of prostate cancer patients based on age, family history, diabetes, hypertension, tobacco habit, clinical extent of disease (risk group) and treatment received. Materials and Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India. During years 1999-2002, some 850 prostate cancer cases, including 371 new cases, treated in TMH were considered as eligible entrants for the study. Five-year survival rates using actuarial and loss-adjusted (LAR) method were estimated. Results: The patient population was distributed uniformly over the three age groups. A larger proportion of the patients were diagnosed at 'metastatic stage' and hormone treatment was most common. 20% patients had history of diabetes and 40% with hypertension. The 5-year overall survival rate was 64%. Survival was 55%, 74% and 52% for '<59 years','60-69 years' and '>70 years' respectively. Non-diabetic (70%), hypertensive (74%), with family history (80%) of cancer, with localized-disease (91%) and treated with surgery, either alone or in combination, (91%) had better survival. Conclusions: The present study showed that prostate cancer patients with localized disease at diagnosis experience a better outcome. Local treatment with either surgery or radiation achieves a reasonable outcome in prostate cancer patients. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies available now.

• Journal of Korean Biological Nursing Science
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• v.19 no.3
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• pp.131-140
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• 2017

Purpose: Dyslipidemia was a known risk factor for cardiovascular disease and was a leading cause of mortality in worldwide. This study aimed to determine the factors associated with prevalence and medication treatment of dyslipidemia in Korean adult population. Methods: In this study, based on the criteria set by the Korean Society of Lipidology and Atherosclerosis, the factors associated with prevalence and medication treatment of dyslipidemia was evaluated in a population of 12,506 people ($age{\geq}20$), who participated in the Korean National Health and Nutrition Examination Survey (2013-2015). The findings were tested by using multivariate logistic regression. Results: Dyslipidemia prevalence rate was 36.5%. Among populations with dyslipidemia, 17.5% were treated with lipid-lowering drugs. In the multivariate logistic regression model, male, increase in age, lower education level, non-drinker, current smoking, less physical activity, increase of body mass index, hypertension, and diabetes were associated with an increased odd of dyslipidemia. Female, increase in age, higher income, excess fat intake, hypertension, diabetes, myocardial infarction, and angina were associated with an increased odd of medication treat. Conclusion: The results of this study could be used to screen patients at the high risk for dyslipidemia or to predict medication adherence.

• Journal of Home Health Care Nursing
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• v.15 no.2
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• pp.67-74
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• 2008

Purpose: We analyzed the need for home care services and awareness of U-healthcare in nurses of the Catholic Parish Home Care Center to link the ubiquitous health care system and the home care. Methods: We recruited 46 nurses from a home care center in the catholic parish of the C medical center from April 4th to June 8th, 2007. Results: The highest needs were 'assessment and diagnosis of the problem', 'management of hypertension & diabetes patients', 'counseling of the patient', and 'counseling of major caregiver and family problems'. Therapeutic nursing showed the highest needs in bedsore care. Nurses want hospital medical records available through the ubiquitous health care system. Conclusion: Home care services are supported from the agency, with high needs in assessing and diagnosing the problem, counseling, and managing of hypertension & diabetes patients. Education and public relations efforts on the U-healthcare system should improve system awareness.

• Journal of Obesity & Metabolic Syndrome
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• v.26 no.1
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• pp.52-60
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• 2017

Background: This study investigated the relationship between depressive symptoms and physical fitness, obesity indices, and vitamin D status in office workers. Methods: The subjects were 514 adults with more 30 years of experience as office workers in the city of Seoul. Lifestyle risk factors, obesity indices, physical fitness, and serum vitamin D levels were assessed with a standardized protocol. The Beck Depression Inventory (BDI) was used to assess depression status. Vitamin D status was assessed by measuring serum 25-hydroxyvitamin D concentrations. Based on the BDI scores, participants were classified into no depression (ND, $BDI{\leq}9$), mild depression (MiD, $10{\leq}BDI{\leq}15$), and moderate depression (MoD, $16{\leq}BDI{\leq}23$) groups. Results: Compared with the high cardiorespriatory fitness group, the low cardiorespiratory fitness (men OR=2.618, women OR=1.596) an middle cardiorespiratory fitness group (men OR=1.256, women OR=1.110) had significantly higher odds ratio for having depressive symptoms, even after adjustment for age, hypertension, diabetes, hyperlipidemia, cardiovascular disease, alcohol intake, smoking, body mass index (BMI), percent body fat (%BF), and waist circumference (WC). Compared with the insufficient or deficient vitamin D group , the sufficient vitamin D group had significantly lower odds ratios for having depressive symptoms (men OR=0.121, women OR=0.114), even after adjustment for age, hypertension, diabetes, hyperlipidemia, cardiovascular disease, alcohol intake, smoking, BMI, %BF, and WC. Conclusion: Vitamin D supplementation and outdoor activities should be key components of a lifestyle intervention against office workers' depression.

• Journal of Acupuncture Research
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• v.33 no.1
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• pp.57-68
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• 2016

Objectives : The purpose of this study was to investigate the correlation between patients' characteristics and the beginning period of improvement, as well as contribute to the efficient management of Bell's palsy patients. Methods : The subjects were 94 patients with Bell's palsy. This study was carried out through the use of an administrative database that included patients' characteristics and clinical information. The analysis of the beginning period of improvement by gender, hypertension, diabetes, drinking history, smoking history and facial palsy history was conducted by independent sample t-test. The analysis of the beginning period of improvement by age, House-Brackmann grade, Yanagihara scale and period receiving Korean medical treatment was conducted by Pearson's correlation analysis. Further analysis of the beginning period of improvement by associated symptoms and seasons was conducted by one-way analysis of variance. Results : 1. Significant correlations were not found between the beginning period of improvement and gender, age, season, smoking history, drinking history, facial palsy history, House-Brackmann grade, Yanagihara scale, hypertension, diabetes or associated symptoms. 2. There was significant correlation between the period of receiving Korean medical treatment and the beginning period of improvement. Conclusion : In this study, the earlier that patients received korean medicine treatment after onset, the earlier that the beginning period of improvement could be seen. Therefore, for the efficient management of facial paralysis patients, it is expected to help secure a baseline.