고혈압·당뇨병 환자의 혈압·혈당 조절에 미치는 의원 기반 만성질환관리사업의 효과
Effects of Chronic Disease Management Based on Clinics for Blood Pressure or Glycemic Control in Patients with Hypertension or Type 2 Diabetes Mellitus
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초록
본 연구는 인천시 만성질환관리사업을 통해 고혈압, 당뇨병 환자의 혈압 및 혈당이 조절되었는지를 평가하고자 수행하였다. 2010년 1년 간 참여의원에 등록한 11,501명을 대상으로 인천시 사업의일환으로 진행된 교육과 필수검사에 따라 혈압과혈당이 조절되었는지를 1년간의 추적관찰을 통해분석하였다. 연구 결과 고혈압의 경우 등록 시점에서 혈압 조절이 안 된 군은 1년 후 교육이 혈압조절에 효과가 있는 반면, 등록 시점에서 혈압조절이 잘 된 군은 1년 후 필수검사가 혈압 조절에효과가 있는 것으로 나타났다. 반면, 당뇨병 환자의혈당 조절과 교육 및 필수검사와의 관련성은 확인하지 못하였다. 본 연구결과를 통해 향후 고혈압환자의 효과적인 만성질환 관리를 위해서는 교육과필수검사의 활성화가 중요하며 이를 위한 적극적인노력이 필요할 것으로 생각된다.
Abstract
Objective: This study aimed to examine the effects of chronic disease management program based on clinics for blood pressure control or glycemic control in patients with hypertension or type 2 diabetes mellitus in Incheon. Methods: An observational follow up study was done on 11,501 patients registrated at clinics from January 1st to December 31st, 2010 in Incheon. Experience of education and mandatory laboratory tests were assessed with the registration data and income status was identified by National Health Insurance data. The odds ratio and 95% confidence intervals were derived from logistic regression models. Results: The experience of education has a positive effect for blood pressure control in the non-control group with hypertension at the time of registration (Odds ratio 1.357, confidence intervals: 1.112~1.655). The experience of mandatory laboratory tests has a positive effect for blood pressure control in the control group with hypertension at the time of registration (Odds ratio 1.738, confidence intervals: 1.387~2.178). But the effects of the experience of education and mandatory laboratory test in patients with type 2 diabetes mellitus were not identified. Conclusions: This study revealed the relationship between the experience of education or mandatory laboratory testing and blood pressure control in patients with hypertension.
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