5 research outputs found
Cost-benefit analysis of the case management for the elderly patients with hypertension
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[μλ¬Έ]The purpose of this study was to analyze economic validity for management of hypertension utilizing case management for the elderly patients.
The subjects were 335 elderly people over 65 years old who were diagnosed as hypertension and received home care from the 70 public health centers where were in Seoul and Gyeong Gi Province from 1st April to 30th Jun, 2007. This study was to approach the yearly cost and benefit from a social perspective.
Total cost are classified as direct and indirect expenditure. Direct expenditure stands for case management including personnel, educational and working expenses and medical cost and medicine for out-patients with hypertension. Indirect expenditure indicates traffic expenses for out-patient care.
The benefit was estimated with the reduced treatment cost for in and out-patients and the treatment cost for out-patients as the direct effect and was calculated with the effect of prevention of complications, time reduction and life extension as the indirect effect.
The data was analyzed by spss v12.o. The study results are as follows;
1) This sample had been conducted from elderly people over 65 years old were 335, female were 233(69.6%), male were 102(30.4%), a mean age of 72.78 years old. 122 people(36.4%) were elementary graduates, 72.2% were under elementary graduates including 120(35.8%) were no education. 258(77%) were received Medicaid, 77(21%) were received Region and Employees Medical Insurance.
2) The control rate of hypertension was 9%(31 people) before the case management, but after the case management, the control rate was increased from 64 percent point to 73% (244 people).
3) The total cost of the case management of hypertension was 557,224 won per personal, the direct cost was 221,474 won, the cost of hypertension treatment was 317,750 won and the traffic expenses as the indirect cost was 18,000 won.
4) The total benefit of the case management of hypertension per personal ranged from minimum 1,792,062 won to maximum 2,202,966 won. The direct benefit per personal ranged from minimum 154,134 won to maximum 437,321 won. The indirect benefit was from minimum 1,637,503 won to maximum 1,765,645 won.
5) Therefore, the net benefit per personal ranged from minimum 1,234,838 won to maximum 1,645,742 won. The cost-benefit ratio was more than 1 as minimum 3.28 to maximum 4.01 on the case management of patients with hypertension.
As a result, the case management for the elderly patients with hypertension had economical validity. Therefore, the case management utilizing are needed to extend and apply for the people who have uncontrolled hypertension.ope
Effect of physical ability, depression and social support on quality of life in low income elders living at home.
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[μλ¬Έ]
In this descriptive correlational study, the focus was on the effects of physical ability, depression and social support on quality of life. The participants were 142 people, 65 years of age or over with low incomes. They lived at home but frequently visited the M social welfare center in Wonju, Korea. Convenience sampling was used. Each participant was visited twice, the first time to collect data through one-to-one interviews and the second, to measure physical ability. The following instruments were used: Barthel Index for ADL, the IADL scale developed by Lawton & Brody (1969), the Geriatric Depression Scale Short Form-Korea Version standardized by Gi Baek Suk (1996) and the social support scale by Jang Sook A (2000), adopted for use with elderly people in institutions and amended for use with elders at home. Quality of life was measured using the scale developed by You Ga No (1986). Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regression using the SPSS PC+ program. The results of this study are summarized as follows :1. Comparing gender, there were more women (74.6%) than men (25.4%). Mean age was 75.65 years but 53.6% were over 76. 50.8% of the Aged earned less than 250,000 won. 2. Physical fitness had a mean score of 2.85 out of 7 points. The mean for the Rohrer scale was 160.80, for grip strength 18.99 kg, getting up and down off a chair, 10.18 times, forward bending, 6.80 cm, one leg stand, 12.27 seconds, 6m walk velocity, 9.48 seconds, and stair climbing, 30.63 seconds. The mean ADL score was 93.34 out of 100, and 35.2% scored 100 points. The mean IADL score was 9.48 out of 12, and 29.6% scored 12 points. 3. Depression scores averaged of 11.11 and 69.7% had a score of 10 or more.4. Support was provided by an average of 3.18 people. Mean social support score for spouse was 7.95, for children, 7.27, for siblings 4.21, for friends, 6.42, and for neighbors, 5.25.5. The average of the quality of life score was 120.07 out of 220.6. Quality of life scores correlated negatively with depression scores (r=-.651, p<.01) and positively with IADL (r=.545, p<.01), physical fitness (r=.454, p<.01), sleep status (r=.338, p<.01), ADL (r=.335, p<.01), leisure activity (r=.285, p<.01), perceived health status (r=.275, p<.01), and spouse support (r=.264, p<.01).7. Variables significantly influencing quality of life were depression (42.4%), IADL (13.4%), sleep status (3.9%), physical fitness (3.3%), ADL (1.7%), spouse support (1.3%), and leisure activity (1.1%). These variables explained 67.7% of the variance in quality of life In conclusion, factors identified as affecting quality of life were depression, IADL, sleep status, physical fitness, ADL, spouse support, and leisure activity. Nursing intervention programs developed to reduce depression in elders should include physical fitness, ADL, spouse support, and leisure activity. These factors must be assessed when planning nursing interventions to reduce depression and improve quality of life in elders at home.ope
A Detection Model of Industrial Accident Related Disease in the National Health Insurance
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