부산 · 경남 지역의 고혈압 사례관리사업 실시 효과 = Effect of the Case Management Program for Hypertension Patients in Busan and Gyeongsangnam-do

다국어 초록 (Multilingual Abstract)

Background : Hypertension is one of the high prevalence disease and 9th common death cause of Korean in 2006. The effective management for hypertension is continuous treatments and maintenance of healthy life style. So, we started this study to verify effect of the case management program as a method for maintenance of hypertension management which is conducted by the National Health Insurance Corporation.
Method : We studied effect of the case management for hypertension patients during the period from January to December in 2006. Investigation subjects were 364 hypertension patients residing in Busan and Gyeongsangnam-do. We conducted the case management program for hypertension patient that case managers in each areas performed 3 times visiting and 1 time phone arbitration according to protocol of the case management program by the National Health Insurance Corporation. We evaluated effect of the case management program based on changes of blood pressure, knowledge level for hypertension, self-management level for hypertension patients. Data analysis was performed with t-test and paired t-test using SPSS Win(ver 12.0K) program.
Result : After the case management program, mean blood pressure was improved from 113.88 ± 29.41 mmHg to 107.84 ± 25.47 mmHg(p<0.01), systolic blood pressure and diastolic blood pressure were decreased from 139.44 ±17.54 mmHg to 130.98 ± 12.82 mmHg and from 88.33 ± 10.73 mmHg to 84.70 ± 7.84 mmHg(p<0.01). The level of knowledge on 9-point scale for hypertension was increase from 5.65 ± 1.77 before the case management to 7.65 ± 1.36 after the case management(p<0.01) and the level of self-management behaviors for hypertension(sum of the score was 35 points) was improved from 22.69 ± 3.96 to 26.06 ± 3.48(p<0.01). Smoking quantity(cigarette per day) and drinking frequency(time per week) were reduced from 14.74 ± 7.48 and 3.45 ± 4.66 to 12.41 ± 8.24 and 2.56 ± 1.74(p<0.05), exercise frequency(time per week) was increased from 4.60 ± 1.75 to 4.79 ± 1.67(p<0.01).
Conclusion : From the result, we can concluded that the case management program conducted by the National Health Insurance Corporation showed decrease of blood pressure, improvements of self-management and knowledge level for hypertension. The case management program for hypertension needs to be developed in a way that increases not only hypertension patient's motivation to manage their diseases but also improvement of public heath system. For the widespread use of the case management program among hypertension patients, media-based promotional campaign and supporting of public health system are much required

목차 (Table of Contents)

• 서론
• 연구대상 및 방법
• 1. 연구대상 및 기간
• 2. 연구방법
• 연구결과
• 1. 연구 대상자의 일반적 특성
• 2. 사례관리에 따른 혈압변화
• 3. 사례관리에 따른 고혈압 지식 및 자가관리 수준의 변화
• 4. 사례관리에 따른 건강관련 행위의 변화
• 고찰
• 결론
• 참고문헌

참고문헌 (Reference)

1 조추용, "사례관리의 이론과 실제" 유풍출판사 2000

2 국민보험공단, "사례관리사업 매뉴얼"

3 Ha YC, "The prevalence, awareness, treatment, and control of hypertension, and related factors in rural Korea" 33 (33): 513-520, 2000

4 Burt VL, "Prevalence of hypertension in US adult population : result from the third National Health and Nutrition Examination Survey 1988-1991" 25 : 305-313, 1995

5 Knight EL, "Predictor of uncontrolled hypertension in ambullatory patients" 38 (38): 809-814, 2001

6 Wallace RB, "Maxcy-Rosenau-Last Public Health &Preventive Medicine" Appleton & Lange 949-957, 1998

7 Izzo JL, "Hypertension Primer" Williams & Willkins 156-166, 1999

8 Kaplan NM, "Clinical hypertension" Williams & Willkins 133-155, 1998

9 통계청, "2006 사망원인 통계 결과(사망원인 순위별 사암자수, 구성비, 사망률)"

10 보건복지부, "2005년도 국민건강 영양조사(검진편)"

11 보건복지부, "2001년도 국민건강 영양조사(검진편)"