HEALTH STATUS MEASURES
Educational objectives
- Describe the principle of constructing an indicator
- Describe the criteria for measuring instruments
- Define, calculate, interpret the main indicators of the health status of the population.
- Explain the interactions between incidence-prevalence, mortality-incidence
- List and describe the different factors that may influence their measurement.
- Understanding the use of routinely available data
- Identify environmental factors that may influence health
HEALTH STATUS MEASURES
I – INTRODUCTION
The identification of population health problems and appropriate interventions in the form of activities or programs require the use of specific evaluation instruments : indicators .
These indicators, developed or chosen from among those that exist, provide information on the health problems studied, the priorities to be established, and the action to be taken.
II – DEFINITION OF AN INDICATOR
It is a variable that allows ∙to describe a given situation
∙to establish priorities
∙to define an action strategy
The study of the evolution of this instrument over time aims to compare several population groups, several sectors with each other and to measure the speed of improvement in the health status of the population.
An indicator must meet certain criteria.
It must be ∙ valid : it must actually measure what it is supposed to measure
∙ objective : the result will be the same regardless of who performs the measurement
∙ sensitive : it must react to changes in the situation
∙ specific : it must reflect changes in the situation in question.
III – CONSTRUCTION OF INDICATORS MEASURING THE STATE OF HEALTH.
An indicator is expressed as a ratio, thus establishing a relationship between two quantities, one placed in the numerator , the other in the denominator .
The numerator relates to the event considered.
The denominator represents the population where the event is observed
In the health field, it quantifies any event relating to health (death, illness, disability, etc.)
This report will be:
∙ a proportion
If the individuals in the numerator are a subset of the denominator: it is a relative frequency between 0 and 1
example 1: if we record 50 deaths from cancer out of 2000 deaths from all causes the proportion will be 50/2000 = 0.025 or 25% 0 if we relate to 1000 people
1000 being a coefficient named K, it can be expressed for 100, 10,000 people, etc.
Example 2: If we record pregnant women receiving prenatal care, we can calculate the proportion of women receiving this care.
∙ A ratio
It is a frequency ratio of two classes of the same variable, thus allowing a comparison.
Example 1: The sex ratio
the variable is gender, the class includes Men, Women.
So this is the M/F ratio.
Example 2: The excess mortality ratio (SM) according to sex will be calculated as follows.
Male mortality rate 100
SM = = = 2
Mortality rate among women 50
∙ A hint :
It is a frequency ratio: it serves as a substitute for a proportion that is difficult to calculate.
For example: we want to calculate the relative frequency of maternal deaths,
in the numerator, we include maternal deaths and in the denominator, women who have given birth.
The denominator is difficult to obtain, so it is replaced by a denominator that is easier to know: live births.
Maternal DC
Fr = ——————————————
Number of live births
Other examples: performance index, equipment index (1 bed per 10,000, 1 doctor per 100 inhabitants.
The index is different from the ratio and the proportion.
∙ A rate:
It is a ratio where the numerator is a part of the denominator that has undergone an event (death, illness, disability), example: morbidity rate, mortality rate
The morbidity rate is the ratio between the number of sick people and the population.
The population will be the population at risk or the average (or reference) population calculated at mid-year.
The calculation of this rate will use the notion of time.
The morbidity rate will be calculated for a given period of time, in a given geographic area, for a given population.
case
Morbidity rate = (PT: persons x observation time or the
PT average population).
Example 1:
A population is estimated at 600,000 people followed for one year.
120 people will develop M. disease over the course of a year.
120
Morbidity rate =————-x 100,000 ha
600,000
ex-2 If not all persons are followed throughout the year,
the calculation will be like this.
If we have 10 people at the beginning of the survey, and if we have 5
at the end of the survey: our denominator breaks down as follows:
5 people were followed for 12 months. PT = 5×12
2 people were followed for 2 months. PT = 2 x 2
1 person was followed for 6 months. PT = 1 x 6
2 people were followed for 8 months. PT = 2 x 8
PT = (5×12)+(2×2)+(8×2)+6 = 86 person-times
If the time is expressed in months we will therefore have 86 people / month
If time is expressed in years,
86
PT = ———————- = 7.2 PA (pers per year).
12
This is the exact calculation.
There is an approximate calculation where
Po: represents the people time, at time t = o, i.e. 10 people
Pt: represents the people time, at time t i.e. 5 people
t: observation time, i.e. 1 year
PT is then the average population
Po + Pt
PT = xt PT = 10 +5 x 1 = 7.5 PA
2 2
A) the measure of morbidity is expressed by the prevalence rate and the incidence rate.
1- Measure by the prevalence rate (T Pr )
It is the ratio between the prevalence (number of existing cases) and the number of people in this population at a given time or period.
a) Instantaneous prevalence rate (T Pri )
TPri = prevalence x K (K=100, or 1000, 10000,)
Pop. at T 1
ex 1. Tuberculosis prevalence rate as of 01.01. 1996
existing tuberculosis cases as of 10.01. 96,200
T P RI = = x K
Estimated population: as of 1. 01.96 300,000
ex2 = Prevalence rate of HVB markers as of 04/30/2002
This is the ratio between existing cases and the exposed population.
b) Period prevalence rate (Prp)
This is the ratio between the prevalence during the period considered and the
estimated population during the period considered.
ex. Tuberculosis prevalence rate during the year 1996
TxPrp: tuberculosis cases recorded during the year 1996
average population of the year 1996
Pop M = Po + Pt (Po: Population 01/01/96, Pt: Pop on 12/31/96)
2
2) Measures by incidence rate
Incidence is the occurrence of cases of disease in a general population or the population at risk.
a) Annual incidence rate
Tx = new cases (year or period) x K
average (or at risk) pop. during the period considered
ex . 1995: 200 breast cancer x 100,000 = 66.6/100,000. Ha.
300,000
b) Incidence rate: incidence density: I. Instantaneous
I I: new incident cases
Tx =
PT PT: person . time
ex. 1990 to 1994: out of 100 women monitored – 10 breast cancers were recorded
10
Tx = = 0.02 / person.year
100 x 5
c) Cumulative incidence Ic (cumulative, risk, probability)
I
I c =
Po I: incident case during the observation period
Po: population at risk at the start of the study period
ex. Incidence of cancer during the 1st quarter of 1997
incident cases 10
Po: as of 1.01.97, 500
Ic = 10 = 0.02
500
Remarks :
1- the attack rate is a particular incidence at short exposure period
eg: food poisoning attack rate.
2- For pathologies occurring in episodes, in the numerator it is necessary
count episodes (e.g. diarrhea, heart attack)
3 – There is a link between incidence and prevalence
P = I x D D: duration of illness
Prevalence depends on two factors, the incidence and duration of the disease. Thus, a change in the prevalence of a disease may reflect changes in its incidence or its duration or both. For example, if a new, more effective treatment prevents deaths, without producing a complete cure, the prevalence of a disease may paradoxically increase.
HEALTH STATUS MEASURES
The decrease in prevalence may be the result not only of a decrease in incidence but also of a shortening of the duration of the disease, due to more rapid recovery or premature death.
If the duration of the disease is sufficiently reduced, the prevalence may decrease despite a concomitant increase in incidence.
The relationship is especially true for a chronic disease that is not very progressive.
In this case, the incidence can be inferred if the prevalence and duration of the disease are known.
Prevalence is used by health planners because it expresses the need for treatments, hospital beds, etc. It is used in planning physical and human resource needs in the health field.
HEALTH STATUS MEASURES
B) The mortality measure is expressed by the crude rate, specific rate and the lethality rate
The measure can be calculated by:
1 / Crude mortality rate (CMR)
This is the ratio between deaths from all causes (DC) and population during the observation period.
DC
TBM = x K
Population
The population is either PT (person-time) or the average reference population: example over a year: we record 32,855 DC in a population of 51,33580 inhabitants.
32855
TBM = = 0.0064 or 6.4 DC / 1000 P/A
51 33580
2 Lethality or case fatality rate (L )
This is the proportion of deaths among people with a disease.
DC
L =
Sick pop
DC: measles
ex. L =
measles case
3/ Specific mortality:
It can be calculated for several variables,
a) age , example infant mortality, perinatal mortality
DC child < 12 months
TMI = x K
live births
Infant mortality is sensitive to the availability, utilization and effectiveness of health care.
Perinatal mortality is an indicator of health care coverage and quality.
b) sex, example maternal mortality rate:
Maternal DC
TMM = x K
live births
c) Causes , for example mortality from uterine or lung cancer.
Noticed:
TM = TxI x L
There is a link between mortality, incidence and lethality rates.
If curative interventions reduce lethality, there will also be a corresponding decrease in mortality.
If preventive measures are taken, the incidence and mortality will be reduced.
The construction of these reports necessarily involves collecting data from different sources of information.
HEALTH STATUS MEASURES
IV – DATA SOURCES:
- The data that allows the construction of an indicator come either
* of a: routine information system
*the establishment of an information system for the collection of data necessary for the study of the problem considered.
Different information systems can be used.
HEALTH STATUS MEASURES
A) In the health sector :
The data is obtained from
– from the permanent recording system coming from
* medical records from hospital services or extra-hospital structures
* consultation records, vaccination, growth control program
demographic (PNMCD)
* chronic disease registers (cancer, diabetes). They allow an incidence to be calculated.
* Communicable Disease Reporting Registry
* Pharmacy data on drug consumption
– or from surveys planned for the study of a particular problem.
B) In the Extra-Health Sector
Data can be obtained
-from permanent recording
* Civil status register
* Reports from gendarmes and police on traffic accidents
* Absenteeism data from schools and factories
*data from patient associations
*social security data
-or special records such as population censuses.
V- AREA OF INTEREST: utility
a) In public health
1) to establish a community diagnosis , the indicators help to define needs, identify population groups and geographical areas requiring support, thus determining risk groups and risk areas.
2) to carry out programming , they allow the definition of criteria, the development of priorities and the quantification of the objectives selected.
3) to carry out the evaluation of public health interventions, they measure the degree of achievement, the level of progress of the programs (results, processes, management of a program, etc.)
4) to ensure epidemiological surveillance .
They make it possible to monitor the evolution of morbidity and mortality within populations, both in terms of communicable and non-communicable diseases.
(Cancer register, RAA…..)
b) In clinical research.
They intervene at the level of research – etiological
– therapeutic
-technical
-evaluative
These studies use the association between health status and its possible determinants
(c) In the general socio-economic development of the country,
They measure factors external to the health sector that influence a country’s social and economic progress.
HEALTH STATUS MEASURES
VI- DIFFERENT TYPES OF INDICATOR (CLASSIFICATION)
Two groups can be identified:
A) Those that directly measure changes related to the intervention at the population level are often outcome indicators.
Example: in the expanded vaccination program (EPI), these are the immunization rate, vaccination coverage, and residual morbidity.
In the population growth control program (PNMCD) it is the contraception rate.
They inform us about the activity carried out in relation to the objectives set (this is the achievement of the objectives) and guide us towards a modification of strategy if necessary).
B) Those that measure the determinants of health . They correspond to the factors, events and characteristics leading to a change in the health status of the population, these are:
- Demographic indicators , such as birth rates, death rates, population distribution by age and sex (age pyramid) by geographic area, life expectancy
- Environmental indicators
We can distinguish:
– the physical environment linked to agents: physical, chemical and biological (climate pollution, etc.)
– the socio-economic environment: housing, work, etc.
- Lifestyle indicators
Although difficult to quantify, it is nevertheless necessary to remember the repercussions of smoking habits, eating habits and alcohol abuse on health.
Smoking
Example: smoking prevalence rate T x Prt = x100
Population
- Health service indicators
The structures act as means of prevention and care.
An assessment will then involve:
– health resource indicators provided by health establishments and staff (statuses, services offered, population coverage, staff/population ratio, etc.)
Regarding health care benefits, the following must be taken into account:
* availability: it is the ratio between the population of a unit
administrative, the health establishment and the staff assigned to it.
*accessibility: this is the proportion of a given population that must use a
establishment, service, etc.
* utilization: this is the number of people using a given service;
compared to the population requiring the service
usage indicators used to describe the activity of establishments and staff: hospital movements
* with more traditional indicators (entry, exit , length of stay, MS, distribution of medication, etc.)
* and more modern indicators: homogeneous groups of patients…..
VII CONCLUSION:
It should not be forgotten that indicators allow us to monitor progress towards health, and for this we sometimes need to establish reference levels, but also to measure changes in relation to these levels which serve as standards.
HEALTH STATUS MEASURES
B ibliography :
1- Jean Bouyer. Epidemiology, principles and quantitative methods chapter 31.
2- WHO – Teacher’s Manual. Elements of Epidemiology page 44 to 49, page 52,
page 90, page 174 and page 176.
3- WHO – Teaching health statistics pages 125 to 128.
4- Clément Beaucage and Yves Bonnier. Applied epidemiology page 40 to 47.
5- Paul Marie Bernard and Claude Lapointe. Statistical measures in epidemiology page
47 to 60.
6- Claude Rumeau Rouquette. Epidemiology, methods and practices
chapter 2 page 13 to 19
chapter 18 page 269 to 273
7- WHO- Development of indicators for the continuous monitoring of progress towards health for all by the year 2000.
Dental crowns are used to restore the shape and function of a damaged tooth.
Bruxism, or teeth grinding, can cause premature wear and often requires wearing a retainer at night.
Dental abscesses are painful infections that require prompt treatment to avoid complications. Gum grafting is a surgical procedure that can treat gum recession. Dentists use composite materials for fillings because they match the natural color of the teeth.
A diet high in sugar increases the risk of developing tooth decay.
Pediatric dental care is essential to establish good hygiene habits from an early age.
HEALTH STATUS MEASURESHEALTH STATUS MEASURES
Educational objectives
- Describe the principle of constructing an indicator
- Describe the criteria for measuring instruments
- Define, calculate, interpret the main indicators of the health status of the population.
- Explain the interactions between incidence-prevalence, mortality-incidence
- List and describe the different factors that may influence their measurement.
- Understanding the use of routinely available data
- Identify environmental factors that may influence health
HEALTH STATUS MEASURES
I – INTRODUCTION
The identification of population health problems and appropriate interventions in the form of activities or programs require the use of specific evaluation instruments : indicators .
These indicators, developed or chosen from among those that exist, provide information on the health problems studied, the priorities to be established, and the action to be taken.
II – DEFINITION OF AN INDICATOR
It is a variable that allows ∙to describe a given situation
∙to establish priorities
∙to define an action strategy
The study of the evolution of this instrument over time aims to compare several population groups, several sectors with each other and to measure the speed of improvement in the health status of the population.
An indicator must meet certain criteria.
It must be ∙ valid : it must actually measure what it is supposed to measure
∙ objective : the result will be the same regardless of who performs the measurement
∙ sensitive : it must react to changes in the situation
∙ specific : it must reflect changes in the situation in question.
III – CONSTRUCTION OF INDICATORS MEASURING THE STATE OF HEALTH.
An indicator is expressed as a ratio, thus establishing a relationship between two quantities, one placed in the numerator , the other in the denominator .
The numerator relates to the event considered.
The denominator represents the population where the event is observed
In the health field, it quantifies any event relating to health (death, illness, disability, etc.)
This report will be:
∙ a proportion
If the individuals in the numerator are a subset of the denominator: it is a relative frequency between 0 and 1
example 1: if we record 50 deaths from cancer out of 2000 deaths from all causes the proportion will be 50/2000 = 0.025 or 25% 0 if we relate to 1000 people
1000 being a coefficient named K, it can be expressed for 100, 10,000 people, etc.
Example 2: If we record pregnant women receiving prenatal care, we can calculate the proportion of women receiving this care.
∙ A ratio
It is a frequency ratio of two classes of the same variable, thus allowing a comparison.
Example 1: The sex ratio
the variable is gender, the class includes Men, Women.
So this is the M/F ratio.
Example 2: The excess mortality ratio (SM) according to sex will be calculated as follows.
Male mortality rate 100
SM = = = 2
Mortality rate among women 50
∙ A hint :
It is a frequency ratio: it serves as a substitute for a proportion that is difficult to calculate.
For example: we want to calculate the relative frequency of maternal deaths,
in the numerator, we include maternal deaths and in the denominator, women who have given birth.
The denominator is difficult to obtain, so it is replaced by a denominator that is easier to know: live births.
Maternal DC
Fr = ——————————————
Number of live births
Other examples: performance index, equipment index (1 bed per 10,000, 1 doctor per 100 inhabitants.
The index is different from the ratio and the proportion.
∙ A rate:
It is a ratio where the numerator is a part of the denominator that has undergone an event (death, illness, disability), example: morbidity rate, mortality rate
The morbidity rate is the ratio between the number of sick people and the population.
The population will be the population at risk or the average (or reference) population calculated at mid-year.
The calculation of this rate will use the notion of time.
The morbidity rate will be calculated for a given period of time, in a given geographic area, for a given population.
case
Morbidity rate = (PT: persons x observation time or the
PT average population).
Example 1:
A population is estimated at 600,000 people followed for one year.
120 people will develop M. disease over the course of a year.
120
Morbidity rate =————-x 100,000 ha
600,000
ex-2 If not all persons are followed throughout the year,
the calculation will be like this.
If we have 10 people at the beginning of the survey, and if we have 5
at the end of the survey: our denominator breaks down as follows:
5 people were followed for 12 months. PT = 5×12
2 people were followed for 2 months. PT = 2 x 2
1 person was followed for 6 months. PT = 1 x 6
2 people were followed for 8 months. PT = 2 x 8
PT = (5×12)+(2×2)+(8×2)+6 = 86 person-times
If the time is expressed in months we will therefore have 86 people / month
If time is expressed in years,
86
PT = ———————- = 7.2 PA (pers per year).
12
This is the exact calculation.
There is an approximate calculation where
Po: represents the people time, at time t = o, i.e. 10 people
Pt: represents the people time, at time t i.e. 5 people
t: observation time, i.e. 1 year
PT is then the average population
Po + Pt
PT = xt PT = 10 +5 x 1 = 7.5 PA
2 2
A) the measure of morbidity is expressed by the prevalence rate and the incidence rate.
1- Measure by the prevalence rate (T Pr )
It is the ratio between the prevalence (number of existing cases) and the number of people in this population at a given time or period.
a) Instantaneous prevalence rate (T Pri )
TPri = prevalence x K (K=100, or 1000, 10000,)
Pop. at T 1
ex 1. Tuberculosis prevalence rate as of 01.01. 1996
existing tuberculosis cases as of 10.01. 96,200
T P RI = = x K
Estimated population: as of 1. 01.96 300,000
ex2 = Prevalence rate of HVB markers as of 04/30/2002
This is the ratio between existing cases and the exposed population.
b) Period prevalence rate (Prp)
This is the ratio between the prevalence during the period considered and the
estimated population during the period considered.
ex. Tuberculosis prevalence rate during the year 1996
TxPrp: tuberculosis cases recorded during the year 1996
average population of the year 1996
Pop M = Po + Pt (Po: Population 01/01/96, Pt: Pop on 12/31/96)
2
2) Measures by incidence rate
Incidence is the occurrence of cases of disease in a general population or the population at risk.
a) Annual incidence rate
Tx = new cases (year or period) x K
average (or at risk) pop. during the period considered
ex . 1995: 200 breast cancer x 100,000 = 66.6/100,000. Ha.
300,000
b) Incidence rate: incidence density: I. Instantaneous
I I: new incident cases
Tx =
PT PT: person . time
ex. 1990 to 1994: out of 100 women monitored – 10 breast cancers were recorded
10
Tx = = 0.02 / person.year
100 x 5
c) Cumulative incidence Ic (cumulative, risk, probability)
I
I c =
Po I: incident case during the observation period
Po: population at risk at the start of the study period
ex. Incidence of cancer during the 1st quarter of 1997
incident cases 10
Po: as of 1.01.97, 500
Ic = 10 = 0.02
500
Remarks :
1- the attack rate is a particular incidence at short exposure period
eg: food poisoning attack rate.
2- For pathologies occurring in episodes, in the numerator it is necessary
count episodes (e.g. diarrhea, heart attack)
3 – There is a link between incidence and prevalence
P = I x D D: duration of illness
Prevalence depends on two factors, the incidence and duration of the disease. Thus, a change in the prevalence of a disease may reflect changes in its incidence or its duration or both. For example, if a new, more effective treatment prevents deaths, without producing a complete cure, the prevalence of a disease may paradoxically increase.
HEALTH STATUS MEASURES
The decrease in prevalence may be the result not only of a decrease in incidence but also of a shortening of the duration of the disease, due to more rapid recovery or premature death.
If the duration of the disease is sufficiently reduced, the prevalence may decrease despite a concomitant increase in incidence.
The relationship is especially true for a chronic disease that is not very progressive.
In this case, the incidence can be inferred if the prevalence and duration of the disease are known.
Prevalence is used by health planners because it expresses the need for treatments, hospital beds, etc. It is used in planning physical and human resource needs in the health field.
HEALTH STATUS MEASURES
B) The mortality measure is expressed by the crude rate, specific rate and the lethality rate
The measure can be calculated by:
1 / Crude mortality rate (CMR)
This is the ratio between deaths from all causes (DC) and population during the observation period.
DC
TBM = x K
Population
The population is either PT (person-time) or the average reference population: example over a year: we record 32,855 DC in a population of 51,33580 inhabitants.
32855
TBM = = 0.0064 or 6.4 DC / 1000 P/A
51 33580
2 Lethality or case fatality rate (L )
This is the proportion of deaths among people with a disease.
DC
L =
Sick pop
DC: measles
ex. L =
measles case
3/ Specific mortality:
It can be calculated for several variables,
a) age , example infant mortality, perinatal mortality
DC child < 12 months
TMI = x K
live births
Infant mortality is sensitive to the availability, utilization and effectiveness of health care.
Perinatal mortality is an indicator of health care coverage and quality.
b) sex, example maternal mortality rate:
Maternal DC
TMM = x K
live births
c) Causes , for example mortality from uterine or lung cancer.
Noticed:
TM = TxI x L
There is a link between mortality, incidence and lethality rates.
If curative interventions reduce lethality, there will also be a corresponding decrease in mortality.
If preventive measures are taken, the incidence and mortality will be reduced.
The construction of these reports necessarily involves collecting data from different sources of information.
HEALTH STATUS MEASURES
IV – DATA SOURCES:
- The data that allows the construction of an indicator come either
* of a: routine information system
*the establishment of an information system for the collection of data necessary for the study of the problem considered.
Different information systems can be used.
HEALTH STATUS MEASURES
A) In the health sector :
The data is obtained from
– from the permanent recording system coming from
* medical records from hospital services or extra-hospital structures
* consultation records, vaccination, growth control program
demographic (PNMCD)
* chronic disease registers (cancer, diabetes). They allow an incidence to be calculated.
* Communicable Disease Reporting Registry
* Pharmacy data on drug consumption
– or from surveys planned for the study of a particular problem.
B) In the Extra-Health Sector
Data can be obtained
-from permanent recording
* Civil status register
* Reports from gendarmes and police on traffic accidents
* Absenteeism data from schools and factories
*data from patient associations
*social security data
-or special records such as population censuses.
V- AREA OF INTEREST: utility
a) In public health
1) to establish a community diagnosis , the indicators help to define needs, identify population groups and geographical areas requiring support, thus determining risk groups and risk areas.
2) to carry out programming , they allow the definition of criteria, the development of priorities and the quantification of the objectives selected.
3) to carry out the evaluation of public health interventions, they measure the degree of achievement, the level of progress of the programs (results, processes, management of a program, etc.)
4) to ensure epidemiological surveillance .
They make it possible to monitor the evolution of morbidity and mortality within populations, both in terms of communicable and non-communicable diseases.
(Cancer register, RAA…..)
b) In clinical research.
They intervene at the level of research – etiological
– therapeutic
-technical
-evaluative
These studies use the association between health status and its possible determinants
(c) In the general socio-economic development of the country,
They measure factors external to the health sector that influence a country’s social and economic progress.
HEALTH STATUS MEASURES
VI- DIFFERENT TYPES OF INDICATOR (CLASSIFICATION)
Two groups can be identified:
A) Those that directly measure changes related to the intervention at the population level are often outcome indicators.
Example: in the expanded vaccination program (EPI), these are the immunization rate, vaccination coverage, and residual morbidity.
In the population growth control program (PNMCD) it is the contraception rate.
They inform us about the activity carried out in relation to the objectives set (this is the achievement of the objectives) and guide us towards a modification of strategy if necessary).
B) Those that measure the determinants of health . They correspond to the factors, events and characteristics leading to a change in the health status of the population, these are:
- Demographic indicators , such as birth rates, death rates, population distribution by age and sex (age pyramid) by geographic area, life expectancy
- Environmental indicators
We can distinguish:
– the physical environment linked to agents: physical, chemical and biological (climate pollution, etc.)
– the socio-economic environment: housing, work, etc.
- Lifestyle indicators
Although difficult to quantify, it is nevertheless necessary to remember the repercussions of smoking habits, eating habits and alcohol abuse on health.
Smoking
Example: smoking prevalence rate T x Prt = x100
Population
- Health service indicators
The structures act as means of prevention and care.
An assessment will then involve:
– health resource indicators provided by health establishments and staff (statuses, services offered, population coverage, staff/population ratio, etc.)
Regarding health care benefits, the following must be taken into account:
* availability: it is the ratio between the population of a unit
administrative, the health establishment and the staff assigned to it.
*accessibility: this is the proportion of a given population that must use a
establishment, service, etc.
* utilization: this is the number of people using a given service;
compared to the population requiring the service
usage indicators used to describe the activity of establishments and staff: hospital movements
* with more traditional indicators (entry, exit , length of stay, MS, distribution of medication, etc.)
* and more modern indicators: homogeneous groups of patients…..
VII CONCLUSION:
It should not be forgotten that indicators allow us to monitor progress towards health, and for this we sometimes need to establish reference levels, but also to measure changes in relation to these levels which serve as standards.
HEALTH STATUS MEASURES
B ibliography :
1- Jean Bouyer. Epidemiology, principles and quantitative methods chapter 31.
2- WHO – Teacher’s Manual. Elements of Epidemiology page 44 to 49, page 52,
page 90, page 174 and page 176.
3- WHO – Teaching health statistics pages 125 to 128.
4- Clément Beaucage and Yves Bonnier. Applied epidemiology page 40 to 47.
5- Paul Marie Bernard and Claude Lapointe. Statistical measures in epidemiology page
47 to 60.
6- Claude Rumeau Rouquette. Epidemiology, methods and practices
chapter 2 page 13 to 19
chapter 18 page 269 to 273
7- WHO- Development of indicators for the continuous monitoring of progress towards health for all by the year 2000.
Dental crowns are used to restore the shape and function of a damaged tooth.
Bruxism, or teeth grinding, can cause premature wear and often requires wearing a retainer at night.
Dental abscesses are painful infections that require prompt treatment to avoid complications. Gum grafting is a surgical procedure that can treat gum recession. Dentists use composite materials for fillings because they match the natural color of the teeth.
A diet high in sugar increases the risk of developing tooth decay.
Pediatric dental care is essential to establish good hygiene habits from an early age.
HEALTH STATUS MEASURES