Control of hypertension and diabetes among adults aged over 40 years with or without physical disabilities

2015 ◽  
Vol 14 (2) ◽  
Author(s):  
Jung-A Lee ◽  
Jong Heon Park
Keyword(s):  
Plasma Glucose ◽  
Screening Program ◽  
Physical Disabilities ◽  
Female Gender ◽  
Healthcare Services ◽  
Tertiary Hospital ◽  
Health Screening ◽  
Effective Control ◽  
Screening Programs ◽  
Glucose Levels

AbstractDisabled individuals have poorer health compared to non-disabled individuals and they exhibit a higher prevalence of chronic diseases, such as hypertension (HTN) and diabetes mellitus (DM). We explored how effectively blood pressure (BP) and fasting plasma glucose (FPG) level, factors influencing development of HTN and DM, were controlled in disabled and non-disabled individuals over the age of 40 years. We hypothesized that control of BP and FPG levels in disabled individuals would be lower than that in non-disabled participants.Records of the National Health Insurance Scheme (NHIS) were analyzed and the health screening program database was examined between the years 2007 and 2009. We identified patients who had used healthcare services to treat HTN or DM. Health-related information that might influence effective control of both BP and FPG levels in those with or without physical disabilities were examined.The extent of effective BP and DM control did not differ between people with and without disabilities, but plasma glucose levels were slightly better controlled in individuals with disabilities than those without disabilities. HTN and DM control was more closely associated with female gender, age, grade of disability, non-smoking and non-drinker status, engagement in physical activity, presentation for health examinations, and frequent tertiary hospital visits for HTN management.Our paper is significant because of our focus on differences between disabled and non-disabled individuals. Our results and future data from NHIS health screening programs can be used to regularly monitor population health status and to evaluate information relevant to the management of HTN and DM control.

scholarly journals Effects of a Dementia Screening Program on Healthcare Utilization in South Korea: A Difference-In-Difference Analysis

2019 ◽  
Vol 16 (20) ◽  
pp. 3837 ◽  
Author(s):  
Su Jung Lee ◽  
Hyun-Ju Seo ◽  
Dong Young Lee ◽  
So-Hyun Moon
Keyword(s):  
Screening Program ◽  
Drug Prescription ◽  
Healthcare Services ◽  
Control Group ◽  
Difference In Difference ◽  
Difference Analysis ◽  
Screening Programs ◽  
Dementia Screening ◽  
People With Dementia ◽  
Prescription Rates

To determine whether Seoul’s dementia screening program increased the rate of diagnosis and the appropriate use of healthcare services for people with dementia, a retrospective data analysis was conducted based on administrative data from the Health Insurance Review and Assessment Service. Two cohorts were constructed to represent the year before Seoul’s dementia screening program began (2007) (control group) and the year after the implementation of the program (2009) (treatment group). A difference-in-difference analysis was used to compare the diagnosis rates, number of clinic visits, and dementia-related drug prescription rates for 4 districts that implemented dementia screening programs between 2007 and 2009 and 14 areas that did not. After the introduction of the program, there was a 55.4% increase in physician-diagnosed dementia. The “average drug cost per patient” increased by 52.2% (Exp(β) = 1.522, p = 0.0264), the “average outpatient visits per patient” tended to increase by 13.5% (Exp(β) = 1.135, p = 0.1852), and the “average outpatient treatment fees per visit per patient” tended to increase by 24.4% (Exp(β) = 1.244, p = 0.0821). The implementation of dementia screening programs led to an increase in healthcare service utilization. Therefore, this program was found to be an effective strategy for reducing undiagnosed dementia cases and encouraging patients to use adequate healthcare services.

scholarly journals Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Josephine Akpalu ◽  
Alfred E. Yawson ◽  
Foster Osei-Poku ◽  
Yacoba Atiase ◽  
Ernest Yorke ◽  
...  
Keyword(s):  
Elevated Temperature ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Odds Ratio ◽  
Female Gender ◽  
Tertiary Hospital ◽  
Older Age ◽  
Stroke Outcome ◽  
Stroke Patients ◽  
Patients With Diabetes

Background. Diabetes mellitus, a well-established independent risk factor for stroke, has varied association with stroke outcome from previous studies. This study investigated stroke outcome and determinants among patients with and without diabetes in a tertiary hospital in Ghana. Methods. A prospective study conducted among stroke patients with and without diabetes admitted in a Ghanaian tertiary hospital. Baseline clinical and biochemical data were documented. Functional stroke outcome was evaluated at 1, 3, and 6 months after stroke using the modified Rankin Scale. Results. Number of participants enrolled were 326 and 105 (32.20%) had diabetes. Higher proportions of diabetes patients had poor functional stroke outcome at 1, 3, and 6 months (79%, 75.23%, 73.33%) compared with those without diabetes (70.13%, 65.16, 61.99) (p>0.05). Stroke patients with diabetes had lower survival compared with those without diabetes (p=0.0745). Mortality at 6 months was more likely among ischaemic stroke patients with diabetes compared with those without diabetes (Odds Ratio 2.037; CI: 1.058-3.923). Determinants of poor functional stroke outcome for diabetes patients were older age (Adjusted Odds Ratio (AOR)-1.07; CI-1.03-1.12), female gender (AOR-3.74; CI-1.26-12.65), and pneumonia (AOR-11.32; CI-1.93-220.05) whereas the determinants for those without diabetes were unemployment (AOR-4.19; CI-1.24-19.50), speech abnormalities (AOR-1.99; CI1.08-3.73), and pneumonia (AOR-4.05; CI-1.83-9.77). High fasting plasma glucose (HR-1.15; CI-1.07-1.23), elevated temperature (HR-1.41; CI-1.11-1.79), and pneumonia (HR-2.25; CI-1.44-3.50) were determinants of low survival among all stroke patients. Conclusion. Trends towards poorer functional outcome and reduced survival were found among Ghanaian stroke patients with diabetes compared with those without diabetes. Older age, female gender, pneumonia, elevated temperature, and fasting plasma glucose were determinants of adverse outcome in stroke patients with diabetes.

scholarly journals Factors Associated with Healthcare Services Utilization and Pharmacological Treatment in Individuals with Diabetes Diagnosis: Lessons from a Nationwide Program for Diabetes Mellitus Detection in Brazil

2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
Maria Isabel Fischer ◽  
Cristiana Maria Toscano ◽  
Sotero Serrate Mengue
Keyword(s):  
Pharmacological Treatment ◽  
Screening Program ◽  
Healthcare Services ◽  
Diabetes Diagnosis ◽  
Services Utilization ◽  
Factors Associated ◽  
Glucose Levels ◽  
Diabetes Status ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes

The Brazilian Nationwide Population Screening Program for Diabetes, conducted in 2001, diagnosed 346,168 new cases. Although unexpected, approximately 65,000 previously diabetic individuals participated. We describe their characteristics compared to new cases, based on data obtained by a follow-up study of a subsample of 4991 positively screened from a representative sample of 90,106 individuals. Two groups were analyzed regarding factors associated with adherence to treatment, healthcare services utilization, and compliance to pharmacological treatment: 497 with newly diagnosed diabetes and 257 individuals with previous diabetes diagnosis who were not under treatment at the screening program. For this group, healthcare service utilization was lower when compared with the new cases (OR = 0.06; 95% CI: 0.03–0.12). Diabetes status (OR = 0.23; 95% CI: 0.14–0.37), a healthy behavior score (OR = 0.53, 95% CI: 0.34–0.83), and glucose levels at screening (altered, OR = 5.01; 95% CI: 2.38–10.6 and likely and very likely DM OR = 11.2; 95% CI: 6.85–18.4) were independently associated with pharmacological treatment.

scholarly journals A Five-year Follow-up Study of Fasting Plasma Glucose Levels in 3,604 Subjects Undergoing Health Screening.

2001 ◽  
Vol 28 (4) ◽  
pp. 429-433
Author(s):  
Hidetaka HORIE ◽  
Yoko SHIBATA ◽  
Shinji MITSUHASHI ◽  
Fumitoshi OHNO ◽  
Seiki SHIINO ◽  
...  
Keyword(s):  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Health Screening ◽  
Glucose Levels ◽  
Follow Up Study ◽  
Fasting Plasma

Some Considerations Pertinent to the Health Screening of Children

1973 ◽  
Vol 12 (11) ◽  
pp. 656-659 ◽  
Author(s):  
Ken Lessler
Keyword(s):  
Screening Program ◽  
Active Role ◽  
Health Screening ◽  
Screening Programs

The pediatrician is in a unique and powerful position, both in his own office and in his community. By taking an active role in designing, executing, and evaluating screening programs, he can help insure that resources are used economically and usefully, and that a broadened view of screening and health results in positive programs. He should insist that vital components of any screening program include intervention and dissemination of information to those who need it. To do less is to abdicate a responsibility which cannot be delegated to others, even though many screening programs are initiated and conducted by nonphysicians.

scholarly journals Feasibility of integrating mental health screening into youth HIV Care in a Low-Middle Income Country Setting

2021 ◽  
Author(s):  
Merrian Brooks ◽  
Bathusi Phetogo ◽  
Makhetha Monyane-Pheko ◽  
Onkemetse Phoi ◽  
Ontibile Tshume ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Professionals ◽  
Screening Program ◽  
Case Reports ◽  
Severe Case ◽  
Health Screening ◽  
Mental Health Screening ◽  
Hiv Care ◽  
Screening Programs

<p><b><u>Introduction</u></b>: Youth living with HIV (YLWH) experience higher rates of mental illness than their peers. Holistic care for YLWH may involve adopting mental health screening programs into comprehensive HIV care to help identify and address mental health concerns in young people. We explored various contexts, procedures, and safety measures throughout the integration and maintenance of a mental health screening program for adolescents attending an HIV referral clinic in Gaborone, Botswana. <b><u>Methods:</u></b> Implementation goals included a safety goal of 100% appropriate referral rate for emergency cases, and a screening goal of 70% of the approximately 1100 adolescent and young adults who were clients of the clinic at least once in the one year review period. Frequent meetings with the behavioral health team and relevant clinic staff were conducted to determine when, where and how to screen the clients. Referral procedures and an emergency protocol for certain “red flag” behaviors was developed to facilitate a warm handing off to trained mental health professionals along with a backup for non-mental health clinicians to assist in the absence of the PSS team. Every other week severe score case reports were produced by the screening team to prevent loss to follow up of suicidal ideation, hallucination or very high scores. Mild to moderate cases were referred to clinicians trained in brief intervention therapy. <b><u>Results:</u></b> Of the 846 clients screened, 191 (19.2%) had severe scores. Eight (4.1%) of these 191 severe case scores were either not immediately reported, or were inappropriately referred. Two of those eight had suicidal ideation and were not immediately referred but were appropriately followed up after being identified during bimonthly implementation team meetings. Identifying a specific trained person tasked with facilitating the screening was found to be most helpful. As was training the clinicians in methods to respond to mild to moderate results, particularly during unavailability of PSS team members. A clear and detailed protocol for severe cases was also noted as a key element in keeping the screening program safe. <b><u>Conclusions:</u></b> Establishing a universal screening program in an LMIC is possible with the consideration of various contextual factors.<u></u></p>

A Statistical Model for Assessing the Need for Medical Care in a Health Screening Program

1973 ◽  
Vol 19 (1) ◽  
pp. 113-116 ◽  
Author(s):  
Stuart C Hartz
Keyword(s):  
Statistical Model ◽  
Medical Care ◽  
Screening Program ◽  
Logistic Function ◽  
Health Screening ◽  
Maximum Likelihood Estimates ◽  
Unknown Parameters ◽  
Linear Discriminant ◽  
Screening Programs ◽  
Health Screening Program

Abstract This is a statistical model (the "multiple logistic model") for pooling data from many variables into a single probability estimate that a person examined in a health screening system requires medical care. Because discrete variables are frequently studied in health screening programs, the required assumption of multivariate normality of the predictor variables related to many statistical techniques is seldom fulfilled. A computing method is given that avoids this assumption by directly assuming the appropriateness of logistic function and obtains the corresponding maximum likelihood estimates (MLE) of the unknown parameters. Fisher’s linear discriminant function (LDF) may be used to provide the initial estimates of these parameters, which are necessary for the application of the MLE computing procedure. The algorithms to estimate these coefficients are discussed for both the LDF and MLE models, and an application of these methods to a set of data is presented and other applications of this procedure are proposed

scholarly journals Health status of veterans with spinal cord injury during screening program in Tehran 2013: Investigating the pulmonary function - a preliminary report

2014 ◽  
Author(s):  
Ghasem Azimi ◽  
Arash Divanbeigi ◽  
Taher Doroudi ◽  
Amir Emami ◽  
Alireza Yarandi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pulmonary Function ◽  
Screening Program ◽  
Care Program ◽  
Health Screening ◽  
Screening Programs ◽  
Cord Injury ◽  
The Mean ◽  
Complete Spinal Cord Injury

Respiratory problems are a major cause of mortality in people with spinal cord injury. More than 2000 veterans with spinal cord injury live in Iran. This study aimed to evaluate the pulmonary function of veterans with spinal cord injury participating in the health-screening program in Tehran-2013. This retrospective descriptive study was conducted by reviewing participants’ medical records. All veterans (368) were male with the mean age of 49.62 ± 6.45 years. The mean time since injury was 27.17 ± 5.03 years; 32 veterans (8.7%) suffered from tetraplegia and 336 (91.3%) were paraplegic; 120 veterans (32.6%) had complete spinal cord injury and 248 had incomplete spinal cord injury (67.4%). Among them, 159 veterans had difficulty coughing; 198 complained of dyspnea and 119 had a history of hospitalization for pneumonia during the last year. It seems that veterans’ pulmonary status in the screening was appropriate indicating the suitability of periodic visits to veterans in the home care program. It is suggested that future studies be conducted simultaneously with health screening programs.

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