• Title/Summary/Keyword: Chronic Diseases Management

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Implications of Managing Chronic Obstructive Pulmonary Disease in Cardiovascular Diseases

  • Deshmukh, Kartik;Khanna, Arjun
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.1
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    • pp.35-45
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    • 2021
  • Globally, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are the leading causes of the non-communicable disease burden. Overlapping symptoms such as breathing difficulty and fatigue, with a lack of awareness about COPD among physicians, are key reasons for under-diagnosis and resulting sub-optimal care relative to COPD. Much has been published in the past on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of the prevalence and impact of COPD management in commonly encountered cardiac diseases is lacking. The purpose of this study was to summarize the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We also discuss the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched PubMed, Scopus, EMBASE, and Google Scholar for studies published 1981-May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. The clinical implications of the diagnosis of COPD in cardiac disease includes the recognition of hyperinflation (a treatable trait), implementation of acute exacerbations of COPD (AECOPD) prevention strategies, and reducing the risk of overuse of diuretics. The pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. The appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thus reducing the risk of mortality, improving exercise tolerance, and quality of life.

Comparisons of obesity indicators for obesity and chronic diseases management among older adults (중·고령인구에서 비만과 만성질환 관리를 위한 비만 측정 지표 비교)

  • Chun, Heeran;Park, Eun-Ja;Kim, Il-Ho;Cho, Sung-Il
    • Korean Journal of Health Education and Promotion
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    • v.31 no.5
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    • pp.109-120
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    • 2014
  • Objectives: This study was to examine the associations between obesity level and major chronic diseases in older population in Korea, using different obesity indicators. Methods: Data was from the 2008 KloSA Biomarker pilot, a nationwide sample of 514 non-institutionalized subjects (age $63.6{\pm}9.8$ years; women 57.2%). Anthropometric information was collected by home visiting nurses. Portable bioimpedence devices(Omran HBF359) were used for measuring fat mass. Obesity cut-offs used the Asian criteria of $BMI{\geq}25$, $WC{\geq}90/85cm$, and $fat%{\geq}25/35$ for men and women. Chronic disease prevalence was defined by physician-diagnosed history of 8 specified diseases. Results: Prevalence of chronic diseases significantly increased with increment of obesity level by BMI, WC and fat %. Odds ratios of acquiring chronic diseases remained significant in the obese group (BMI OR 2.76, 95%CI 1.82-4.19; WC OR 2.73, 95%CI 1.81-4.11; Fat OR 1.87 95%CI 1.26-2.78), after adjusting for age, sex, marital status, education, work participation, household income, smoking, drinking, and exercise. Conclusions: Obesity measured by all three indicators, BMI, WC, and fat mass cannot be disregarded, accentuating the significant effect on increases in disease risks among older population. BMI and WC measure appeared better to assess the risks of chronic diseases.

A Study on Factors Causing the Burden of Medical Expenses to The Elderly with Chronic Disease (만성질환 노인의 의료비부담 관련요인에 관한 연구)

  • Kim, Mee-Hye;Kim, So-Hee
    • Korean Journal of Social Welfare
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    • v.48
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    • pp.150-178
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    • 2002
  • The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.

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Perceptions of School Health Care among School-aged Children and Adolescents with Chronic Disease: An Integrative Review (만성질환을 가진 학령기 아동·청소년의 학교 건강관리에 대한 인식: 통합적 문헌고찰)

  • Uhm, Ju-Yeon;Choi, Mi-Young
    • Child Health Nursing Research
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    • v.26 no.2
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    • pp.309-322
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    • 2020
  • Purpose: The purpose of this integrative review was to synthesize previous research on perceptions of school health care among school-aged children and adolescents with chronic diseases. Methods: This study was performed in accordance with Whittemore and Knafl's stages of an integrative review (problem identification, literature search, data evaluation, data analysis, and presentation of the results). Four databases (PubMed, CINAHL, Embase, and Web of Science) were used to retrieve relevant articles. Results: Eighteen articles were included in this review. We identified five thematic categories: peer-related issues, a safe school environment, self-perception of an existing disease, self-management, and a supportive school environment. Conclusion: It is necessary to establish a school health care system with a supportive environment for children and adolescents with chronic diseases.

Considerations for the Dental Management of Older Adults (임상가를 위한 특집3 - 노인 환자의 치과 치료시 고려 사항)

  • Kho, Hong-Seop
    • The Journal of the Korean dental association
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    • v.49 no.10
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    • pp.609-617
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    • 2011
  • The geriatric population is the most rapidly growing part of the general population, which leads to an increase of chronic conditions and illnesses that will influence both oral and systemic health. The most common chronic diseases in elderly population are arthritis, hypertension, heart diseases, diabetes, and cognitive impairment. Chronic impairments such as visual, hearing, orthopedic, and speech disorders are also prevalent among older adults. All these chronic conditions have potential oral complications and the treatments of systemic diseases also has implications for the maintenance of oral health. Therefore, oral health care professionals should catch up with increasing knowledge in this field and can modify the treatment strategy for older adults. In addition, oral health care professionals should understand the changing need of oral health problems in this age and prepare the future demand.

A Study on the Prevalence and Risk of Family History for Chronic Diseases: Findings from the Korea National Health and Nutrition Examination Survey 2019 (만성질환에 대한 가족력의 유병률과 위험도에 관한 연구: 국민건강영양조사(2019)를 중심으로)

  • Lee, Nan-Cho;Kim, Min-Ju;Choi, Hee-Jin;Lee, Jongseok;Jung, Deuk
    • Journal of Convergence for Information Technology
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    • v.11 no.8
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    • pp.160-167
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    • 2021
  • This study was conducted to empirically analyze the prevalence and risk of chronic diseases in the family history of chronic diseases using data from the Korea National Health and Nutrition Examination Survey 2019. Based on 5,691 people, after controlling for socio-demographic variables that were related to family history of chronic diseases, logistic regression analysis was performed to verify the odds ratio, which was the risk of family history of chronic diseases for the prevalence of chronic diseases. The main results were founded that Odds ratio, which was the risk of chronic diseases in groups with a family history compared to those without a family history, was statistically significant at hypertension(2.623), dyslipidemia(1.868), diabetes(1.964), and arthritis(1.435) when gender, age, income status, education level and residence were controlled. These results suggest that it is not only necessary to develop a standardization tool for family history tests, but also a health and disease management system for members with a family history in terms of preventive medicine in health care. This study is significant in that it proposed a practical plan in terms of health care by controlling variables that affect the prevalence of chronic diseases and empirically identifying the risk of family history of chronic diseases.

Implementation of U-Healthcare System for Chronic Disease Management (만성 질환자 관리를 위한 U-Healthcare 시스템 구현)

  • Ryu, Geun-Teak;Choi, Hun
    • Journal of the Institute of Electronics and Information Engineers
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    • v.51 no.1
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    • pp.233-240
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    • 2014
  • According to the recent increasing trend of the ages, numbers of patients with chronic diseases are increasing and issues for health care are importantly emerged. In this thesis the research implements U-health care system for health care of patients with chronic diseases. The suggested system for health care of patients with chronic diseases composes bio measurement system, mobile gateway and medical information management server, and bio-signals are composed with modules such as electrocardiogram, blood pressure, blood sugar, oxygen saturation if configured as client. Blood sugar check was considered and implemented to be chosen the ways to transmit through bio measurement system or through gateway. Suggested bio measurement system and mobile gateway are transmitted through Bluetooth. The transmitted biodata is searched by observing health check through mobile gateway, by transmitting through network server, and by using client. By implementing bio signal observation system of patients with chronic diseases, present health check is available by monitoring measured bio data, and various bio signals are transmitted in the mobile environment.

Medical Experiences and Unmet Health Care Perception among Elderly People with Chronic Disease (만성질환을 가진 노인의 의료경험과 미충족의료 인식)

  • Min, Dong-Hoo;Cho, Jung-Yeon;Kim, Jeong-Gil;Seo, Su-Jin;Kim, Mi-Kyung;Shim, Eun-Hye;Cha, Yu-Hyun;Kim, Chang-Yup
    • Health Policy and Management
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    • v.28 no.1
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    • pp.35-47
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    • 2018
  • Background: The purpose of this study is to elucidate the context of medical experience and the perception of unmet healthcare of elderly people with chronic diseases based on in-depth interview data. Methods: We carried out in-depth interviews with 10 elderly people with chronic diseases using semi-structured questionnaires based on literature review. The in-depth interview data were analyzed using thematic analysis; one qualitative research methodology, three core meaning categories, and four attributes associated with unmet healthcare were ultimately derived. Results: The context of the medical experience were based on the following three categories: (1) discomfort due to diseases and high medical needs, (2) the poor community medical environment and difficulties in accessing to metropolitan medical institutions, and (3) inconvenience caused by long waiting time and side effects of medicine. In addition, the elderly with chronic disease realized the unmet healthcare as (1) the availability related to the desired medical institutions at the right time, (2) the affordability related to their economic capacity, (3) the effectiveness of the medical services they experienced, and (4) the appropriateness related to receiving medical services in a pleasant environment. Conclusion: The perception of unmet healthcare among the elderly with chronic disease is the result of interaction of multi-level and multi-dimensional factors related with their medical experience.

Cost of Illness of Chronic Disease by Region in Korea (3대 만성질환자의 지역별 의료비 분석)

  • Moon, Jong Youn;Shin, Jaeyong;Kim, Jae-Hyun
    • 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.

Effects of Health Behaviors Related to Chronic Diseases in City Workers (일개 도시지역 근로자의 건강행태에 따른 만성질환 관련성)

  • Kim, Kyung-Hee;Chun, Byung-Yeol;Kwon, Gi-Hong
    • Journal of Convergence for Information Technology
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    • v.8 no.3
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    • pp.17-24
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    • 2018
  • This study aimed to investigate the relationship between the health behavior and prevalence of chronic disease in 5,638 city workers. Data were analyzed with frequency, percentage, chi-square test, logistic regression analysis. The results showed that the health behaviors of the subjects were high smoking and drinking, low exercise, and the prevalence of chronic diseases was high in obesity and hyperlipemia. The major influencing factors of chronic diseases were age, exercise and drinking. This study suggests that it is necessary to operate a systematic health management program for the desirable health behaviors in the national, local, and industrial fields.