Consultation Social Med

7/28/2019 Consultation Social Med

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MINISTRY OF HEALTH OF UKRAINENATIONAL MEDICAL UNIVERSITY OF IVANO-

FRANKIVSK

PRACTICALLY-ORIENTED STATE

EXAMINATION

Department of social medicine,organization and economy of health

service


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Part 1 Student get an individual situational

task The purpose is to represent medical

information processing skills

The subject of task are public health

indexes


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Stages of situational task

solution1. To determine source of

information used in situational

task

2. To calculate indexes

3. To represent results in a tableand represent graphically


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Stages of situational task

solution3. To analyze calculated index

4. To make conclusion and determinemain factors, influencing on theindex rate

5. To substitute actions onoptimization of the studiedphenomenon and work out

practical recommendations


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Estimation of practical task The results of practical task should

be written of protocol blank

Teacher-examiner estimate eachstage of practical task solution

You can get: 1, 0.5 and 0points


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Examination Blank


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Examples of situational

tasks(part 1)1. To calculate birth rate, death rate and

natural increase

2. To calculate death rate and structure ofdeath cases over reasons

3. To calculate age structure of urban andrural populations

4. To calculate infant mortality rate,neonatal mortality rate and the part ofneonatal death in infant mortality

5. To calculate perinatal mortality rate, early

neonatal mortality rate and stillborns rate


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tasks(part 1)6. To calculate prevalence rate and the structure

of disease cases

7. To calculate incidence rate and the structure

of disease cases

8. To calculate incidence rate of viral hepatitis A

9. To calculate prevalence rate and incidence

rate of tuberculosis, part of destructive form

among new cases of tuberculosis


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tasks(part 1)10.To calculate cancer incidence rate, late

diagnostic and lethality over a one-year

period among new cancer cases

11.To calculate primary disability rate and

the structure of disability

12.To calculate length of hospital stay in

general and length of hospital stay with

different diseases


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Example of situational

task(part 1)There were 52000 persons in the cityN. this year. During this year 650

children were born and 900 personsdied.

Birth rates in previous four yearswere: 15.2; 14.6 ; 13.4 and 12.7 .

Death rates in previous four yearswere: 15.2 ; 15.6 ; 16.7

and 16.9 .


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The task:1. To determine source of information used

in situational task.2. To calculate birth rate, death rate and

natural increase.3. To represent results in a table and

represent graphically.4. To analyze calculated indexes.

5. To make conclusion and determine mainfactors, influencing on the indexes rates.

6. To substitute actions on optimization ofthe studied phenomenon and work out

practical recommendations.


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Task solution1.To determine source of information

used in situational task Medical birth certificate (must be

changed on Birth certificate in a

public registry office during onemonth)

Physicians death certificate

Physicians death certificate aboutperinatal dearth (must be changedon Death certificate in a publicregistry office during three days)


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Task solution2.To calculate indexes

Birth rate = 650*1000/52000 =

12,50 (low)

Dearth rate = 900*1000/52000 =

17,30 (high)

Natural increase = 12,50-17,30 =

- 4,80 (negative, depopulation)

k l i


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Task solution3.To represent results in a table and

represent graphically Line diagram

8,7 8,8

7,1

6,0 6,06,5

5,6

8,68,58,1

8,0

10,810,511,0

9,4

7,3 7,56,7

5,5 5,4

9,1

7,67,2

8,8

7,8

7,87,8

7,97,1

0,0

2,0

4,0

6,0

8,0

10,0

12,0

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

100.


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Part 2 Student get two individual situational

tasks (2a and 2b)

The purpose of task 2a is to represent

skills of medical documents filling

The purpose of task 2b is to representskills of doctors working activity

estimation


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Estimation of practical task

The results of practical tasksshould be written of protocol blank

Teacher-examiner estimatesolution of each task practical

You can get: 1 or 0 points foreach part


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2a. Task solutioncase of out-patient treatment

Medical card of ambulatory patient

Statistic talon for registration of thefinal (specified) diagnoses

Control card of dispenser supervision

Sick list


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Depends on case

Tuberculosis (standart accounting form fordirection of patient to phthisical

dispensaries) Malignancy neoplasm (standart

accounting form for direction of patient tooncological dispensaries)

Immediate message of contagious disease Direction to the medically-social expert

commission

Medical death certificate


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2a. Task solutioncase of in-patient treatment

Medical card of in-patient treatment

Statistic card of patient discharged

from hospital

List of doctors prescriptions

Temperature list

Sick list

Extraction from medical card

2 T k l ti


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(women's center) Individual medical card of pregnant

women

Medical card of pregnant womenfrom women's center (exchangecard)

Sick list from the 30th week ofpregnancy for 70 days and 56 daysafter delivery


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2 T k l ti


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2a. Task solutioncase of out-patient treatment,

children's policlinic Medical card of a child

Card of preventive vaccination Statistic talon for registration of the

final (specified) diagnoses


Sick list for working parents


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Example of situationaltask(part 2a)

Mr. Lee, 49 years-old, works on thefactory. He had chronic bronchitis

during 5 years. Last time he hadaggravation of disease in April. Hewas treated in policlinic from the11th of April till the 2nd of May.

Determine all medical documents forregistration of this case. What arethe peculiarities of medical

documents filling?


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Example of situationaltask solution(part 2a)

Medical card of ambulatory patient


Statistic talon for registration of the final(specified) diagnoses, marked by -

Sick list is given out by doctor from the11th till the 15th of April. Then doctorcontinue this list from the 16st till the20th of April. Doctor with the chief ofdepartment prolongs the sick list from the

21st of April till the 2nd of May


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Example of situationaltask(part 2a)

Mr. Becone, 47 years-old, during hisworking day got trauma of right

hand. Three fingers were amputatedat the time of operation. He was inthe hospital during 2 weeks. He cantwork any more in the same place.

Determine all medical documents forregistration of this case. What arethe peculiarities of medical

documents filling?


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Example of situationaltask(part 2b)

Head pediatrician of the region needsto work out a year report about his

working activity.

What main parts and indexes should

contain this report?


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Situational tasksolution

(part 2b)4. Estimation of health care facility activity:

- out-patient (analysis of population

providing by doctors, quantity of persons forone therapeutic district, quantity of visits at

home and in the policlinic for one hour,

prophylactic activity estimation: patronageregularity, coverage of population by

medical examinations; quality and

effectiveness of dispanserisation)


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- in-patient (analysis of bed found usage:

occupancy rate of beds fund, averageoccupation of hospital bed in a year, average

circulation of hospital bed; hospitalization

structure, middle durations of treatment,lethality, lethality over different reasons,

surgical activity of the doctor, postoperation

lethality)


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- out-patient, women's center:

Prophylactic activity estimation: part of pregnant women taking

into supervision before 12 weeks of pregnancy; patronage terms

and regularity, part of late diagnostic of womens cancer, coverage

of women by medical examinations; quality and effectiveness of

dispanserisation;

Analysis of women's health indexes, demographic indexes,

maternal death rate, perinatal death rate, morbidity level,

incidence and prevalence of womens reproductive system

diseases, disability


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(part 2b)4. Estimation of health care facility

activity:

- in-patient, maternity hospital

(maternal death, perinatal death,

complications during delivery andoperations, newborns morbidity)


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(part 2b)4. Estimation of health care facility

activity:

- in-patient, maternity hospital

(maternal death, perinatal death,

complications during delivery andoperations, newborns morbidity)


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(part 2b)5. Forms of qualification improvement

(post-diploma education,

specialization, conference, scientific

seminars etc)

6. For head physicians (providing bydoctors, level and quality of doctors

qualification, technical and financial

provisionof the facility)


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(part 2b)7. Conclusions

8. Practical recommendationsfor

improvement of work and

increasing of population healthlevel


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I wish you

good lack!!!

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