Weeks One And Two Flashcards
Define a census
The simultaneous recording of demographic data by the government at a particular time pertaining to all the persons who life in a particular territory.
List three reasons to consider medicine from a population rather than individual perspective.
Evaluate the efficacy of interventions and investigate causes of disease
Allocate resources by monitoring a predicting incidence/prevalence of a disease, plan healthcare.
Consider the impact of decisions related to patient care on other patients in terms of available resources, or for example inappropriate antibiotics/risks of immunisation.
List the salient features of the UK census.
Takes place every 10 years (except 1941 - war)
Legally obliged to take part
Confidential, cannot use for sampling
Carried out by office of national statistics in England and Wales.
Why do we need a census?
Measure population size in each area - allocation of resources.
Plan health and social care
Plan schools
Plan new housing
Policies relating to employment /investment.
Planning of roads and public transport.
Measure the success of equal opportunities and allocate resources to ethnic groups.
How do we estimate the number of people missed in the census?
Dual system estimation - two counts of a population which are then matched.
What measures are taken in the census to increase the number of responders?
Legal obligation and £1000 fine
Post to every household, complete online or on paper.
The questionnaires from people in communal establishments were collected by enumerators.
What’s the integrated household survey (IHS)
Survey that runs continuously, particularly useful to measure incidence of smoking.
What is the health survey for england?
Measures health and health related behaviours in adults and children in England.
What requires statutory registration?
Birth, death, marriage.
What is included on a death certificate?
Events leading to death.
Diseases which contributed but didn’t directly cause death.
When do mortality rates provide a good estimate of incidence of a disease?
When a disease is rapidly and universally fatal, for example lung cancer.
What are the advantages of using mortality rates?
Almost complete as statutory registration.
Unlikely to be in any doubt over whether someone died or not.
What are three possible measurements of morbidity?
The number of people affected.
The number of illnesses/periods of illness experienced.
The duration of illness.
Define morbidity
Any departure, subjective or objective, from physical and psychological wellbeing.
What are the functions of cancer registries?
Monitor trends in incidence, prevalence and survival with time, and in different socioeconomic groups and areas.
Evaluate the effectiveness of prevention and screening.
Evaluate the effectiveness of treatment.
Look at the effect of social and environmental factors and shape policies designed to reduce health inequality.
Support recalls of specific groups.
How are communicable diseases monitored?
Statutory reporting of 33 communicable diseases (notifiable communicable diseases), voluntary reporting of non notifiable communicable diseases.
What is COVER?
Cover of Vaccinations Evaluated Rapidly
Monitors immunisation coverage in the population
How are congenital abnormalities reported and what is the data used for?
Voluntary national registers.
Audit of antenatal screening techniques and monitor environmental causes of birth defects.
Is reporting abortions statutory, and what is the data used for?
Yes.
Evaluate the impact of contraception and plan services.
What is HES and what is it used for?
Hospital episode statistics, collects information on each hospital admission and outpatient attendance.
Commissioning of services, inform public health policies, provide picture of health of England across time and areas.
How is data from primary care collected?
GP Patient register dataset - live information on all registered patients held by local authorities. Annual extracts held by ONS, used for population and migration statistics.
Quality and outcomes framework (QOF) voluntary reward and on time programme to resource and reward good practice.
Also provided disease registers - may not reflect prevalence but useful.
What problems may be encountered with health data?
Completeness/people being counted twice
Accuracy
Variations in diagnosis/change in criteria over time
Numerator and denominator mismatch - different definitions.
Indirect measurement of events, may be affected by other factors
Confidentiality
What are the advantages of using routine data?
Quick and cheap.
What is the CBR?
Crude birth rate - live births per 1000 members of the population
What’s the GFR?
General fertility rate - number of live births per 1000 women aged 15-44 years.
What is the TPFR?
The total period fertility rate - the number of children that would be born to a hypothetical woman in her life who experiences the age specific fertility rates for that particular year throughout her life.
It is also the sum of age specific fertility rates.
What can lead to differences between the measures of fertility between areas?
Difference in population structure that are accounted for by TPFR, but not CBR, or GFR.
What is fecundity, and what affects it?
Physical ability to reproduce. Affected by sterilisation and hysterectomies.
What is fertility, and what affects it?
Realisation of fecundity as live births.
Increased sexual activity, better economic climate increase fertility
Contraception, abortion decrease fertility.
What is CBR useful for?
Describing the impact of births on the population size.
What is GFR useful for?
Comparing fertility of fertile female population
What is TPFR useful for?
Comparing fertility of fertile female populations, removes the influence of the population structure.
What is the CDR?
Number of deaths per 1000 people in a population.
What is the ASDR?
Age specific death rate - the number of deaths per thousand people in a particular age group.
What is an SMR?
Standardised mortality ratio - compares the observed number of deaths with the expected number of deaths in a reference population with the same age and sex structure.
What affects population size and structure?
Births, deaths and migration.
Why is fertility difficult to predict?
Determined by social behaviour.
