C02 community medicine P08 MORBIDITY INDICATORS.ppt

very good presentation

1. MORBIDITY AND OTHER
INDICATORS OF HEALTH

2. HEALTH – WHO DEFINITION
“ HEALTH IS A DYNAMIC STATE OF COMPLETE
PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL
WELL BEING AND NOT MERELY AN ABSENCE
OF DISEASE OR INFIRMITY ”.

3. INDICATORS OF HEALTH
MORTALITY INDICATORS
MORBIDITY INDICATORS
DISABILITY RATES
NUTRITIONAL STATUS INDICATORS
HEALTH CARE DELIVERY SYSTEMS
UTILIZATION RATES
INDICATORS OF SOCIAL AND MENTAL HEALTH

ENVIRONMENTAL INDICATORS
SOCIO-ECONOMIC INDICATORS
HEALTH POLICY INDICATORS
INDICATORS OF QUALITY OF LIFE
OTHER INDICATORS

4. MORBIDITY--DEFINTITION
“ ANY DEPARTURE SUBJECTIVE OR
OBJECTIVE FROM A STATE OF WELL
BEING ”.

EQUIVALENT TO
SICKNESS,ILLNESS,DISABILITY

5.  MORBIDITY RATES
INCIDENCE AND PREVALENCE

NOTIFICATION RATES
ATTENDANCE RATES AT OUT-PATIENT
DEPARTMENTS,HEALTH CENTRES.

ADMISSION,READMISSION AND DISCHARGE RATES

DURATION OF STAY IN HOSPITAL
SPELLS OF SICKNESS OR ABSENCE FROM WORK OR
SCHOOL.

6. MEASUREMENT OF MORBIDITY:
1. INCIDENCE :IT IS DEFINED AS “THE
NUMBER OF NEW CASES OCCURING IN A
DEFINED POPULATION DURING A SPECIFIED
PERIOD OF TIME”

2. PREVALENCE: IT REFERS TO ALL CURRENT
CASES(OLD AND NEW) EXISTING AT A GIVEN
POINT IN TIME OR DURING A DEFINED PERIOD
OF TIME.

7. INCIDENCE :INCIDENCE :

9. USES OF INCIDENCE:
TO CONTROL DISEASE
FOR RESEARCH INTO AETIOLOGY AND
PATHOGENESIS, DISTRIBUTION OF DISEASE
AND EFFICACY OF PREVENTIVE AND
THERAPEUTIC MEASURES.

10. PREVALENCE:
•2 TYPES
•A. POINT
PREVALENCE
•B. PERIOD
PREVALENCE

11. POINT PREVALENCE =

12. PERIOD PREVALENCE:

13. USES OF PREVALENCE:
IT HELPS TO ESTIMATE THE
MAGNITUDE OF HEALTH / DISEASE
PROBLEMS IN THE COMMUNITY AND
IDENTIFY POTENTIAL HIGH- RISK
POPULATION.
PREVALENCE RATES ARE ESPECIALLY
USEFUL FOR ADMINISTRATIVE AND
PLANNING PURPOSES.

14. ILLUSTRATION OF INCIDENCE
AND PREVALENCE

15. RELATIONSHIP BETWEEN INCIDENCE

AND
PREVALENCE

16. SUMMARY OF VALUE OF MORBIDITY
THEY DESCRIBE THE EXTENT AND NATURE OF DISEASE LOAD
IN THE COMMUNITY AND ESTABLISHMENT OF PRIORITIES.
THEY PROVIDE A COMPREHENSIVE AND AN ACCURATE
CLINICALLY RELAVANT INFORMATION ON PATIENT
CHARACTERISTICS THAN CAN BE OBTAINED FROM
MORTALITY DATA.

THEY SERVE AS STARTING POINT FOR AETIOLOGICAL
STUDIES AND THUS PLAY A CRUCIAL ROLE IN DISEASE
PREVENTION.

THEY ARE NEEDED FOR MONITERING AND EVALUATION OF
DISEASE CONTROL ACTIVITIES.

17.  DISABILITY RATES
•TWO TYPES –
• EVENT TYPE INDICATORS:
•1. NUMBER OF DAYS OF RESTRICTED ACTIVITY
•2. BED DISABILITY DAYS
•3. WORK –LOSS/ SCHOOL LOSS DAYS)WITHIN A SPECIFIED PERIOD
• PERSON- TYPE INDICATORS:
•1. LIMITATIONOF MOBILITY
•2. LIMITATION OF ACTIVITY

18. SULLIVAN’S INDEX
THE INDEX IS COMPUTED BY
SUBTRACTING FROM THE
LIFE EXPECTANCY THE
PROBABLE DURATION OF
BED DISABILITY AND
INABILITY TO PERFORM
MAJOR ACTIVITIES.
FOR EX:
LIFE EXPECTATION FOR ALL
PERSONS IN U.S.A IN 1965
WAS 70.2YRS WHILE
EXPECTATION OF LIFE FREE
OF DISABILITY WORKED
OUT TO BE 64.9YRS.

20. HEALTH ADJUSTED LIFE
EXPECTANCY(HALE)
•TO MEASURE HEALTHY
LIFE EXPECTANCY


•IT IS EQUAL TO THE
NUMBER OF YEARS IN
FULL HEALTH THAT A
NEW BORN CAN EXPECT
TO LIVE BASED ON
CURRENT RATES OF ILL-
HEALTH AND MORTALITY.

21. HALE[HEALTH ADJUSTED LIFE
EXPECTANCY] AND LIFE EXPECTANCY :

22. DISABILITY- ADJUSTED LIFE
MEASURE OF BURDEN OF
DISEASE IN A DEFINED
POPULATION AND THE
EFFECTIVENESS OF THE
INTERVENTIONS.

EXPRESS YEARS OF LIFE
LOST TO PREMATURE
DEATH AND YEARS LIVED
WITH DISABILITY .

“ONE DALY IS ONE LOST
YEAR OF HEALTHY LIFE”.
YEAR (DALY)

23. NUTRITIONAL STATUS INDICATORS
oIT IS A POSITIVE HEALTH
INDICATOR
o3 IMPORTANT INDICATORS:
o1. ANTHROPOMETRIC
MEASUREMENTS OF
PRESCHOOL CHILDREN.


o2. HEIGHTS OF CHILDREN
AT SCOOL ENTRY


o3. PREVALENCE OF LOW
BIRTH WEIGHT

24. INDICATORS OF NUTRITIONAL STATUS
MATERNAL ,INFANT & PRESCHOOL CHILDREN---
1. BIRTH WEIGHT
2. PROPORTION BEING BREAST FED AND PROPORTION ON WEANING
FOODS,BY AGE IN MONTHS ,MORTALITY RATES IN CHILDREN
AGED1,2,3&4YEARS WITH EMPHASIS ON 2 YEAR OLDS
3. IF AGE KNOWN: HEIGHT FOR AGE: WEIGHT FOR AGE
4. IF AGE UNKNOWN : WEIGHT FOR HEIGHT
MID ARM CIRCUMFERENCE
CLINICAL SIGNS & SYNDROMES
SCHOOL CHILD NUTRITION---
1. HEIGHT FOR THE AGE
2. WEIGHT FOR HEIGHT AT 7 YEARS.

25. MEASURING DEVICES:

26. MID-ARM CICUMFERENCE MEASUREMENT:

27. HEALTH CARE DELIVERY
INDICATORS
FREQUENTLY USED
INDICATORS:
1. DOCTOR –
POPULATION RATIO
2. DOCTOR – NURSE
RATIO
3. POPULATION – BED
RATIO
4. POPULATION PER
HEALTH/SUBCENTRE
5. POPULATION PER
TRADITIONAL BIRTH
ATTENDANT

28. Model of health care delivery system:

29. HEALTH MANPOWER IN SOME COUNTRIES
2004
countryDoctors
per
1000
populati
on
Beds per
10000
populati
on
Nurses
per
1000
populati
on
Midwive
s per
1000
populati
on
INDIA0.7 8.9 0.8 0.47
BANGLA
DESH
0.26 3.36 0.14 0.18
SRILAN
KA
0.55 29 1.58 0.16

30. HEALTH CARE DELIVERY SYSTEMS

31. UTILIZATION RATES

IT IS EXPRESSED AS THE
PROPORTION OF PEOPLE IN
NEED OF A SERVICE WHO
ACTUALLY RECEIVE IT IN A
GIVEN PERIOD USUALLY A
YEAR.

FACTORS AFFECTING:

1.AVAILABILITY
2.ACCESSIBILITY
OF HEALTH SERVICES

3.ATTITUDE OF AN
INDIVIDUAL TOWARDS HIS
HEALTH &HEALTH CARE
DELIVERY SYSTEM.

32. EXAMPLES OF UTILIZATION RATES
1.PROPORTION OF INFANTS
WHO ARE “FULLY IMMUNISED”
AGAINST 6EPI DISEASES.


2. PROPORTION OF PREGNANT
WOMEN WHO RECEIVE
ANTENATAL CARE OR HAVE
THEIR DELIVERIES SUPERVISED
BY A TRAINED BIRTH
ATTENDANT.

3.PERCENTAGE OF POPULATION
USING VARIOUS METHODS OF
FAMILY PLANNING.

4. BED OCCUPANCY RATE.

5. AVERAGE LENGTH OF STAY.
6.
BED TURN – OVER RATIO.

33. UTILIZATION RATES

34. MENTAL HEALTH:
IT IS NOT MERE ABSENCE OF MENTAL
ILLNESS.

GOOD MENTAL HEALTH IS THE
ABILITY RESPOND TO MANY VARIED
EXPERIENCES OF LIFE WITH
FLEXIBILITY AND A SENSE OF
PURPOSE.

36. CHARACHTERSTICS OF A MENTALLY
HEALTHY PERSON
oPERSON IS FREE FROM INTERNAL CONFLICTS .

oHE IS WELL ADJUSTED .
oHE SEARCHES FOR IDENTITY .
oHE HAS A STRONG SENSE OF SELF ESTEEM.

oHE KNOWS HIMSELF.
oHE HAS GOOD SELF-CONTRO-BALANCES
RATIONALITY AND EMOTIONALITY .

oHE FACES PROBLEMS AND TRIES TO SOLVE THEM
INTELIGENTLY.

37. SOCIAL HEALTH :
SOCIAL WELL BEING –” QUALITY AND
QUANTITY OF AN INDIVIDUAL INTER
PERSONAL TIES AND EXTENT OF
INVOLVEMENT WITH THE
COMMUNITY” .

ROOTED IN “POSITIVE MATERIAL
ENVIRONMENT “AND “POSITIVE
HUMAN ENVIRONMENT”.

38. SOCIAL HEALTH :

39. INDICATORS OF SOCIAL AND MENTAL
HEALTH
•INDIRECT INDICATORS OF SOCIAL AND MENTAL
PATHOLOGY :
•1.ACTS OF VIOLENCE AND OTHER CRIME.
•2.ROAD TRAFFIC ACCIDENTS,JUVENILE
DELINQENCY,ALCOHOL AND DRUG ABUSE,SMOKING,
CONSUMPTION OF TRANQUILIZERS,OBESITY.
•3.FAMILY VIOLENCE,BATTERED BABY,BATTERED WIFE
SYNDROMES AND NEGLECTED AND ABONDONED
YOUTH IN NEIBOURHOOD .