Health information Flashcards
Describe the key fertility measurements
Crude birth rate: number of live births per 1,000 population per year in a defined population
General fertility rate: no. of live births per 1,000 women aged 15-44 per year
Age specific fertility rate: no. of births to women of a particular age/age band per year
Total fertility rate: average number of live children a women would bear over lifetime based on current age specific rates
Completed fertility rate: number of children actually born per women in cohort of women up to end of child bearing years
Describe some key mortality indicators (adult and child)?
Crude mortality rate: deaths due to any cause / (population at risk x period of time)
Age specific mortality rate: deaths per age group / (population at risk in age group x time)
Neonatal mortality: deaths < 28 days / number of live births
Infant mortality: deaths < 1 year / number of live births
Maternal mortality: maternal deaths while pregnant or within 42 days of termination due to pregnancy related causes / live births
Wat are the features and advantages / disadvantages of surveys:
-Information on health of whole population (not just those accessing services)
-In depth questions
-Standardisation of questions or examination
Advantages:
-Various modes of administration (face to face, online etc.)
-Can be used for any topic
-Validated instruments exists (SF-36)
-Can include qualitative info
-Enables a range on analyses
Disadvantages:
-expensive
-response rate
-validity and reliability
-selection (and other) bias
-confidentiality needed
-generalisability
Health info suited to surveys:
-determining risk factors
-detecting mild disease
-quality of life
-monitoring progress towards targets
-user satisfaction
-disease prevalence
What is the proportional mortality ratio?
Proportion of deaths occurring from a given cause for a particular occupation relative to the proportion of deaths from that cause in the whole population e.g. 10% suicide rate in bankers compared to 5% in population
Name some sources of occupational health data?
-Employment demographic data
-Size of workforce (census)
-Employment related mortality data (death certificates)
-ONS longitudinal study
-sickness absence reporting
-occupational disease and injury registers
-ill health retirement
-incidents of toxic or hazardous substances
What is health adjusted life expectancy?
Measure of population health that takes into account mortality and morbidity
-Adjusts overall life expectancy by the amount of time lives in less than perfect health
-Calculated by adjusting life expectancy to adjust for years lived with disability
Define QALYs and DALYs
QALY is a generic measure of disease burden, including both the quality and the quantity of life lived. It is used in economic evaluation to assess the value of medical interventions. One QALY equates to one year in perfect health. QALY scores range from 1 (perfect health) to 0 (dead).
One DALY represents the loss of the equivalent of one year of full health. DALYs for a disease or health condition are the sum of the years of life lost to due to premature mortality (YLLs) and the years lived with a disability (YLDs) due to prevalent cases of the disease or health condition in a population.
What is the difference between life expectancy and healthy life expectancy?
“Compression of morbidity” occurs when healthy life expectancy increases as a proportion of life expectancy (people are living longer in good health)
“expansion of morbidity” occurs when healthy life expectancy decreases as a proportion of life expectancy
Life expectancy will differ depending on the use of current (period) mortality rates or historic (cohort) rates - as mortality rates are declining the actual life expectancy for a cohort will normally be higher
cohort life expectancy uses projected changes in future mortality rates.
Name some routine data sources for mental health?
-PHE mental health intelligence network ((community mental health, mental health disorders, suicide prevention, severe mental illness)
-Health survey for England (annual) - includes Warwick-Edinburgh mental wellbeing scale (WEMWBS) to measure mental wellbeing and the General Health Questionnaire (GHQ) to identify mental illness
What are the pros and cons of qualitative research?
Pros:
-Complement quantitative research
-Provide answers to the ‘why’ and ‘how’ things work / don’t work
-Identify gaps between evidence based approaches and issues in implementation
-Provide information to replicate programmes elsewhere
Cons:
-generalisability limited
-cannot infer cost effectiveness
-needs to be analysed using correct methofs
How would you forecast prevalence of dementia in 10 years time?
-Projected all-cause age/sex specific mortality rates
-Apply the current age/sex specific dementia prevalence estimates
-Stratify the forecast by sex as well as age
USE PREVALENCE DATA NOT INCIDENCE
Key assumptions:
-No significant change to the population (e.g. due to migration)
-No significant change in incidence of dementia or duration
-Accuracy of current data
-No major changes in treatment
How can patient and public engagement be improved?
-Selection with clear job description and person specification
-Training appropriate to the role
-Mentorship
-Empowering PPI member to be heard ‘safely’
seeking views through existing fora (e.g. voluntary organisations, patient groups)
-use of social media
-ToR for group
-payment of expenses
Challenges (sociological):
Different levels of knowledge between group members
-Concepts of power, interest and ideology
-Ensuring representative user and carer involvement in service planning
-role of health professionals in society
-using a co-production approach at all levels
list the characteristics of a good indicator
-relevant to the issue
-easy to measure and timely data
-not possible to game / doesn;t deliver disincentives
-has broad stakeholder agreement
-part of a boarder range of indicators
-objective measurment
-realistic and achievable
-reflects an important part of what it is trying to measure
-is a valid measurmemtn
-is meaningful
-can detect issues that need investigation
-can be communicated to otherts
What is the difference between disability, impairment and handicap?
Impairment: bodily functions; e.g. missing limb or mental disorder
Dyability: relates to activities, e.g. being unable to walk
Handicap: relates to social roles, e.g. being unable to work somewhere due to lack of disable access
The Barthel score is used to assess disability and handicap
What are the features of a population disease registry?
-Defined population base
-Clear case definition
-Long term conditions e.g. diabetes
-Needs a clear purpose e.g. improvement / optimisation of care
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