Health Imporvment

Question 1

What two strategies are there in the left shift?

Answer 1

• population strategy (entire population approach but many individuals not helped)
• high risk strategy (high risk score people targeted and helped)

Usually use both

Question 2

What is population level health improvement

Answer 2

Physical and mental health

Improving the health of an entire population
Within/ across defined local, regional, national population

Reducing health inequalities

Reduce occurrence ill health, action deliver appropriate health/ care services

Question 3

Virtuous cycle of public health

Answer 3

Health improvement & early intervention -> I loved health & equality -> greater personal/ population wellbeing -> reduced pressure on health/ social care -> money saved to invest in prevention/ health improvement ->

Question 4

Fundamental requirements for health improvement

Answer 4

Evidence of what works and anticipated benefits

Planning and implementation of interventions

Evaluation and next steps

Understanding population level health needs

Question 5

How can we understand population level health needs?

Answer 5

Research 
Routine data
Health needs assessment 
Health equity audit
Service improvement & evaluation

Question 6

What categories are there in logic models?

Answer 6

Inputs

Outputs/ activities

Short term outcomes

Medium term outcomes

Long term outcomes

Question 7

4 levels of prevention

Answer 7

Primordial - before risk factors developed to eliminate, general population

Primary - disease prevention/ screening, reduce risk disease, susceptible population

Secondary - screening/ treatment, slow progression of disease, asymptomatic population with pathology

Tertiary - treatment/ rehabilitation, minimise consequences of disease, symptomatic patients

Question 8

Define screening

Answer 8

Presumptive identification of unrecognised disease or defect

From those who probably have a disease to probably do not

Application tests, examinations, other procedures

Question 9

What is lead time bias?

Answer 9

Early diagnosis falsely appears to prolong survival, patients actually live the same length of time but longer knowing they have the disease

Question 10

Difference between sensitivity and positive predictive value?

Answer 10

Use sensitivity of test (ability to pick up who is truly diseased) to determine what patient is interested in, PPV ( likelihood of having the disease after positive test result)

Question 11

What is length time bias?

Answer 11

Screening programmes better at picking up slowing growing, unthreatening cases

Diseases detectable more likely to have favourable prognosis and may never have caused a problem

False conclusion screening is beneficial