STATE EXAMINATION SITUATIONAL TASK The average annual population size of the area is 91 thousand, in current year there were born 820 children, died - 1370 people. 5 years ago mortality was 13 %s, The proportion of persons aged 60 and over has increased over this period from 12% to 15%. Morbidity of gastric cancer has increased from 21 to 28 per 100 thousand population, mortality from this disease has increased by 15%, in 45% of patients, cancer was diagnosed on 3-4 stages, and the whole region, this figure does not exceed 30%. Comprehensiveness of medical observation Of able-bodied citizens has decreased by 18%, the number of medical visits per one patient has decreased from 8.2 to 6.5 due to the reduced number of doctors in outpatient-clinics. Percentage of deviations in water samples of potable water-supply sources by chemical indicators has in ed from 12,5 + 1,0 to 16,5 + 0,9%. Solution steps health and health system e 5 5 2 B % . mm eo ee ee ee oe ee aA Ta is i Tv ve U in Wace) P 5 D F (e] ia J 4 e ‘ a es x (ei Vv 13} iN} MSolution steps 4 \dentify information sources that were used to describe health and health system performance. 2. Make statistical calculations. 3. Assess the health state of population. 4. Specify the factors that influenced the health state of population. 5. Suggest measures to improve the health of the population.STEP 1. Identify information sources that were used to describe health and health system performance SITUATIONAL TASK The average annual population size of the area is 91 thousand, in current year there were born 820 children, died - 1370 people. Percentage of deviations in water samples of p sources by chemical indicators has in 2 wai ed from 12,5 + 1,0 to 16 a # $ o a & * fi ny = e mee Oe os i | Aes s a wpe rs 7 7 u 4 | P ONG te D I 35 G al P| 4 = = * PE x a Vv cy nN Ny 7 ; Fr Es . oO) Se) =STEP 1. Identify information sources that were used to describe health and health system performance Demography situation:Data of census and statistical data of the State Statistics Service Birth certificate Death certificate Population health and health system performance: outpatient's medical record report on diseases registered in the polyclinic’s service area Notice of patient with cancer or other neoplasms, that was diagnosed for the first time in the life sick-leave report of the health facility : Acts of sampling water. Water sample study protocolsSTEP 1. Identify information sources that were used to describe health and health system performance SITUATIONAL TASK The average annual. population size of the area is 91 thousand, in current year there were born 820 children, died - 1370 people. Percentage of deviations in water samples of potable water-supply sources by chemical indicators has increased from 12,5 + 1,0 to 16,5 + 0,9% ra # ry a A a * ( ai Fé Ke 4 4 6 7 r} i) 0 5 w E R T 7 U 11\o P x Ss D F ic) a J K LP 2. Make statistical calculations -1 The average annual population size of the area is 91 thousand, in current year there were born 820 children, died - 1370 people. RAL intensive indicators (level, frequency, prevalence)= whole phenomenon e 100 (1000, 10000, 100000 POPULATION intensive indicators (level, frequency, prevalence)= part of the phenomenon e 100 (1000, 10000, 100000) of the POPULATION 0 x 1000/91000= 9%o Mortality) = 1370 x 1000/91000 = irth rate- death rate. + 15%0 = - 6%o. S fe » = = ¢ fo) cy ie) < oSTEP 2. Make statistical calculations -1 The average annual population size of the area is 91 thousand, in current year there were born 820 children, died - 1370 people, intensive indicators (level, frequency, prevalence)= Whole phenomenon e 100 (1000, 10000, 10000 ) POPULATION intensive indicators (level, frequency, prevalence)= art of the phenomenon « 100 (1000, 10000, 100000) of the POPULATIONSTEP 2. Make statistical calculations - 3 5) The number of medical visits per one patient has decreased from 8.2 to 65. 8,2- 100%, 6,5-x%, X=6,5 x 100/ 8.2 = 79%. Visibility indicator = 79-101 6)" 21%. Percentage of deviations in water samples of potable water-supply sources by chemical indicators has ased from 12,5 + 1,0 to 16,5+ P h2,5—16, 0 +09: (>2) The difference betwee two indices is: le when t < les of wa mr i a4 A A * r 6 ri E a 7 8 9 ny & i Z M4 iv) 1 fio P x Pp) i G ct J K i . > x Ge Vv (3) iN) uti , : i % E Ply optionSTEP 3. Assess the health state of population The state health of the population of the area during 5 years has deteriorated. \tevidenced by an nth rate 5.4%, negative the incre t 33% , as well as the great ‘ i greatly exceeding the data by region (30%).STEP 4. Specify the factors that influence the health state of population The deepening of the aging process (proportion of Persons aged 60 and over has increased from 12% to 15%), environmental deterioration (the increase in the Percentage of deviations in water samples of potable water-supply sources by chemical indicators) , decrease of a number of visits widespread harmful habits among the population. Quality of medical care can be associated with sufficient resources (staff, medical equipment, information, economic ) and using scientifically based management. id cy co ad c7 5 i i] a ca ee J vs cs] i] ie) i i i 7 U 1 fo i 2 D i fc) rl J te . : (a 4STEP 5. Suggest measures to improve the health of the yulati \mprovem n i ol The health service or the sanitary-epidemiological service should Strengthen Sanitary control over the environmental situation: decrease the environmental pollution by organizational and technical Measures including n itu teduced emissions of harmful substances into the atmosphere and reducti of harmful substances to the maximum allowable concentrations in the workplace of enterprises improve access to and quality of health care: optimize the number of medical personnel and their qualification improve the equipping of me institutions with modern diagnostic and treatment equipment, including with the use of teleme population, promotion increasing the com| Pr A % i A f [ N Ky Z & 6 7 8 i i) ag fate poe eee) || | ol \ a D [F G ia J K S 5 (a 4\n the city of 220 thousand inhabitants there were feporting year. 2400 people i born 2180 children in the died during the year. In jant mortality rate was 10,0 ‘tho. The share of neonatal m The city has a large chemical plant, which employs the majority of the working Population of the city. Over the past years among the employees of this chemical plant increased the number of working women of childbearing age. Frequency of threatened abortion among these women for 5 years increased from 18,0+1,1 60, The frequency of normal births in chem ortality is 52 %. For women working at a the city is | plant, this figure corresponds to 48, 0 According to the sur family doctors fulfilled 85 birth rate was 12 gynecologists and al the share of neonatal de years ago in the ci mortality rate — 12Step 1.Information sources * statistical data of the State Statistics Service * Medical certificate of birth * Doctor's certificate of death «Ind in + The sick-leave P & * r 5 3 v1 cy ra) 7 E 9 ie} E rs if ¥ U 1 fo ® D a G ca J i \ < Pa (8% Vv i) iN) M‘ ea 2. Make statistical calculations. Coefficient of correlation. 4. The evaluation of association according to direct, reverse of associations according to the coefficient of correlation (module): Week: r= from 0 to 0,29; Average (moderate): r = from 0,3 to 0,69 = from 0,7 to 0,99 of correlation coefficier Reliable ciation (connection) between events or signs when the t> 3 UnreliableSituational task 3 Population size of the area - 55 000, the proportion of people of retirement age in three years increased from 20.2% to 23.6%. In the Teporting year 75 000 registered cases of diseases, including for the first time revealed 35,000. Three years ago, the prevalence of diseases was 1380 "0, primary morbidity - 540 %o.\e hospitalization rate for this period increased from 18.2% to 21.8 % tandardized indices of hos, tion rate are 20.9% and 18. ntyear2. Construct t d quency of abortions per 1000 bom alive in two of causes of disability of the population’. foup and combinational tables: ‘The morbidity of rural population according to profession groups, sex and seas« 5. Continue: of s Cc el ors list): “Study of eg x GS v B nN] NN6.1.Construct a pete m, the years (in %o) in the Figure. The mortality rate dynamics during 5 years (in %.) in the region D ry c N vn6.2. Construct a diagram the fol of abortions per 1000 born “quency of abortions dynamics per 1000 born al in two countries during 5 yearsTOU MORBIDITY OF RURAL POPULATION ACCORDING TO PROFESSION GROUPS, SEX AND SEASONS. Worbiiy [Profession groups | Gender Seasons Workers fg] Surman] Autumn6.4. Make models of the group and combinational tables: “The morbidity of rural population according to profession groups, sex and seasons”. MORBIDITY OF RURAL POPULATION ACCORDING TO PROFESSION Winter Vorker6.6. Define the object and the unit of supervision while studying the injuries among children in the region V. while studying the injuries among children in the Tegion V is: the general number children with the injuries in the region Vv or general number of injuries diagnosed among children in the region Vv is one child with the injure or one case of injury among children in the ré