Form № Н – 3.04

STATE INSTITUTION OF HIGHER EDUCATION “I.Y.HORBACHEVSKY TERNOPIL STATE MEDICAL UNIVERSITY OF THE MINISTRY OF PUBLIC HEALTH OF UKRAINE”

(full name of university)

 

Department of Social Medicine, Organization and Economics of Health Care, and Medical Statistics

 

“APPROVED“

First Vice Rector

Ihor R. Mysula, M.D., Ph.D

August 29, 2013

 

 

Syllabus

 

Social medicine and organization of health care

 (code and name of discipline)

training course                             1201 Medicine

(code and name of the field of study)

specialty                                       7.12010001 “General Medicine”

                                                                                            (code and name of specialty)

faculty                                        Medical

 (name of institution, faculty, department)

 

 

 

 

 

 

 

 

Academic Year 2013 – 2014

 

Syllabus on biostatistics for students

(name of discipline)

Field of Training 1201 Medicine, Specialty 7.12010001″ General Medicine”

 

The author:

Panchyshyn N.Ya. PhD., associate prof., Department of Social Medicine, Organization and Economics of Health Care, and Medical Statistics.

(authors, their positions, academic degrees and titles)

 

 

 

 

Syllabus approved at the Department of Social Medicine, Organization and Economics of Health Care, and Medical Statistics

 

 

Minutes No 1 as of August 27, 2013

 

 

Head of Social Medicine, Organization and

Economics of Health Care, and

Medical Statistics department,

____________________   (Shulhai A.H.)

 

 

 

 

 

 

 

Ó__________, 2013 year

Ó __________, 2014  year

 

 

1. Description of the Discipline

 

Note.

Ratio of classroom hours to self-study and individual work is (in %):

for full-time study – 54,8 : 45,2

 

2. Purpose and objectives of the discipline

Purpose: The purpose of Social Medicine and Health Care Organization is to study human health, depending on the external environment, especially the social conditions of life.

Objectives:

·        studying of population health status and the impact of social conditions, development of methodologies and methods for studying of public health;

·        searching and developing for needs of public health practice organizational forms and methods of medical care and health management;

• training and education of doctors in grounded socio-medical basis.

 

As a result of studying of the discipline the student should

know:

–        theoretical foundations, current principles and legal foundations of public health;

–        organization and the quality of different types of treatment and preventive care and sanitary epidemiological welfare of the population in terms of health care reform;

–        the concept of disability, its types, the order of examination performance;

–        laws and principles of management;

be able to:

–         identify and analyze the main indicators of public health in conjunction with the factors affecting it;

–         develop measures for improving public health and some of its contingents;

–         identify tactics health professionals on specific situations of examination disability;

–         develop management decisions aimed at improvement of basic health care institutions.

 

3. Program of Academic discipline

 

MODULE 1.

STATISTICS OF HEALTH. ORGANIZATION OF BASIC TYPES OF HEALTH CARE FOR POPULATION AT ITS MODERN LEVELS

 

Content module 1

Introduction to Social Medicine and Organization of Health Care.

 

SPECIFIC OBJECTIVES:

·           know the definition of social medicine and health care as a sciences and teaching of the subject and its importance for public health practice;

·           know the history of public health, the stages of its formation;

·           interpret targeted approaches to the definition of “health”;

·           know the indicators of population health;

·            know the methods of social medicine and their possible application in the study of public health and the organization of its medical support;

·            learn the influence of the main factors that determine the level of public health and analyze the features of this influence;

·            know the classification of risk factors to assess the potential impact on public health.

 

Theme 1. SOCIAL MEDICINE AND ORGANIZATION OF HEALTH CARE AS SCIENCE. OBJECT, METHODS, VALUE FOR PRACTICE OF HEALTH CARE.

 

Social Medicine and Health Care Organization – a science that studies the laws of public health and its protection system.

The development of social medicine, the value of work B.Ramatstsini, Y.P.Frank, I.L.Danylevskuy, S.Smit. The formation of social medicine as a science, the role of A.Hrotyana E. Resle, A.Fisher.

A socio-medical direction of rural medicine in Ukraine:

M. Uvarov, M. Tezyakov, P. Diatropov, S. Igumnov, A. Smidovich et al.

The development of social medicine in the works of Ukrainian scientists of the twentieth century: O.Korchak–Chepurkivskuy, M.Hurevychy, S.Kahana, S. Gurevich, S.Tomilin, A.Merkov, L.Lyekarev, K.Duplenko, I.Horosha, A. Grando H.Lukjanov.

The concept of system analysis, statistical, demographic, historical, experimental, epidemiological, economic, sociological methods, methods of peer review, modeling, forecasting.

The value of social medicine for the formation of health care.

 

Theme 2. PUBLIC HEALTH AS A MEDICAL AND SOCIAL PROBLEM. HEALTH STRATEGIES.

 

Targeted approaches to the definition of “health“: general philosophical, individual theoretical, practical individual, population.

Understanding health as a state of complete physical, mental and social well-being not only the absence of disease or physical disabilities.

Public health as conventional statistical concept, its health indicators: demographic (fertility, mortality, life expectancy), physical development, morbidity, disability, frequency prenosological states.

Leading groups of factors that affect the health indicators: the level and way of life of people, environmental conditions, biological factors, accessibility and quality of health care.

Dependence of human health standard of living: the gross domestic product (GDP), Human Development Index (HDI).

The influence of lifestyle on health of population, medical health indicators dependence on factors of different origin.

Peculiarities of health of different age and sexand professional groups.

The health status of some groups of population who are in different ecological conditions.

The health status of some groups of population who are in different ecological conditions.

The concept of quality of life related to health conditions as a combination of life support and health that allows to reach physical, mental and social well-being and self-fulfillment.

 

Theme 3. METHODS OF STUDY OF FACTORS OF POPULATION’S HEALTH.

 

Methodological approaches to the study of factors that determine the level of public health and its separate contingents.

Peculiarities of study the influence of socio-economic factors, socio-biological, ecological and natural and climatic, medical organization. Problems of collecting the relevant information.

The application of techniques and methods of biostatistics (derivatives and averages, the method of standardization, correlation and regression analysis, parametric and non-parametric estimation of results of research, scoring, rating score).

Compliance with the requirements evidence-based medicine.

Classification of risk factors that affect health.                                          

 

Content module 2

Medical and social aspects of demography.

Methods of study of demographic indices.

 

SPECIFIC OBJECTIVES:

• know the definition of demography and its components;

• understand the patterns of formation of demographic situation in Ukraine of its features;

• interpret the factors that affect the reproduction of the population;

• be able to fill registration documents for the study of natural movement the population;

• identify and analyze natural movement of population indicators.

 

Theme 4. Medical and social problems of demographic processes. Features of demographic indices in different regions of the world, in separate countries and in Ukraine.

 

Demography as a science. Parts . Sources of information about the amount, composition and movement of population. The history of the census. Dynamics in the number and composition of the population in some regions of the world and countries in Ukraine. Medical and social importance of this information. Major trends inherent in Ukraine and other countries of the world in relation to urbanization , sex and age composition of the population. Medical and social importance of migration . Vital statistics .

Regional features of fertility in Ukraine and the world today.

The total mortality of the leading causes in different regions, different countries and Ukraine . Sex- and age-old territorial characteristics mortality .

Infant mortality (infant mortality). Value of indicator for the evaluation of health status, level of social and economic well-being and development of society. Leading causes.

Dynamics of infant mortality rate in recent years in Ukraine compared to European countries and other parts of the world.

Regional disparities in infant mortality in Ukraine.

The average life expectancy definition. The essence of the methodology for determining the index, its dynamics in different countries and in Ukraine.

 

Theme 5. Methods of study and estimation of indices of natural movement.

 

Documents are used to study natural movement of population. The possibilities of their application.

Procedure for registration of births in Ukraine. The essence of the concepts of “live birth“, “stillbirth“, “fetal death”. Method of determination and assessment of general and specific fertility rates.

Overall mortality. Procedure for registration of deaths in Ukraine. Methods of studying mortality determine the general and specific indicators of value and evaluation.

Natural population growth.

 

Theme 6. Methods of study and estimation of indices of mortality in babies.

 

Procedure for registration of infant mortality (infant). Methods of determination indicators of the total, neonatal, infant mortality, postneonatal .

Assessment of the relationship of these parameters, the types of infant mortality: A B C. Perinatal mortality.

Infant mortality rates for boys and girls features seasonal infant mortality. The leading causes of infant mortality in different age periods of the first year of life.

The main groups of factors influencing the levels of infant mortality (biological, environmental, medical, organizational, lifestyle ).

Methods of peer review of infant mortality.

 

 

Content module 3

Medical and social aspects of morbidity.

Methods of study of morbidity.

 

SPECIFIC OBJECTIVES:

• explain the medical and social importance of disease;

• know methods of studying disease, its types;

• interpret key trends in incidence depending on the influence of different factors;

• get acquainted with the contents of the main state target programs for socially important diseases;

• be able to fill out registration documents for the registration of certain types of disease;

• identify and analyze morbidity: a common, contagious, important non-epidemic, hospitalized.

 

Theme 7. Morbidity of population as a medical and social problem. Epidemiological methods of morbidity study.

 

The concept of the disease, the goal of the study. Medical and social importance of disease as the leading cause temporary or permanent disability, death.

The impact of disease on the need to ensure public health services, the health of future generations.

The economic costs of the disease, including of socially significant diseases and dangerous.

Methods of studying the disease, the possibility of using certain methods, their advantages and disadvantages.

Application of epidemiological research in the study of non-communicable diseases.

Factors affecting the completeness of data on the incidence , depending on the methods of study.

International Statistical Classification of Diseases, Injuries and Causes of Death, the principles of its construction and meaning.

             Types of disease being studied in Ukraine.

  Differences in the incidence of urban and rural population of different age and sex groups.

 

Theme 8. Tendencies and features of separate types of morbidity in different regions of the world, countries (socially-meaningful and dangerous diseases).

 

Comparative evaluation of methods for the study of disease in countries with different health systems.

Information sources for the study of certain types of disease.

Possibilities of studying of certain types of disease in different countries, trends in morbidity, age and sex characteristics in the world, in countries with different economic development, climatic and natural conditions.

         Diseases of the circulatory system, cancer, neuro-psychiatric disease, diabetes, tuberculosis, AIDS, trauma, alcoholism, drug addiction and substance abuse as a health and social problem. Leading factors affecting these diseases. Dynamics of key indicators.

         The value of an integrated approach to reduce the incidence of certain types: Inter-integrated program “Health of the Nation for 2002-2011” (2002).

 

Theme 9. Methods of study and estimation of indices of general morbidity.

 

The study of the incidence according appeals for help.

The study of general morbidity: a unit of observation, registration documents, rules of filling. Methods of determination of initial incidence and prevalence of diseases, their assessment, regional peculiarities.

Dynamics of indicators of total incidence.

 

Theme 10. Methods of study and estimation of indices of infectious, important non-epidemic and hospital morbidity.

 

Features accounting infectious, important non-epidemic, hospitalized. The records rules for filling them out.

Methods of determination of these types of disease, evaluation, regional specialties.

Dynamics of indicators of Infectious Diseases, important non-epidemic, hospitalized morbidity.

 

Content module 4

Organization of medical and prophylactic care for urban and rural population.

SPECIFIC OBJECTIVES:

·           know the basic principles of treatment and preventive care to the population of Ukraine, including family medicine (general practice);

·           interpret legal principles of medical care, the value of primary health care (PHC);

·           know the types of treatment and preventive care;

·           interpret the nature of outpatient, inpatient and emergency care;

·           know the basics and specifics of treatment and preventive care of urban and rural population;

·           know the content and organization of the family doctor;

·           analyze the feasibility of implementing different models of PHC in Ukraine;

·           know the organization and content of the outpatient clinics and inpatient facilities;

·           know the organization and content of the emergency medical care facilities (EMC);

·          know the nature and features of the medical and social welfare of older people;

·          be able to fill in registration documents of health care facilities;

·          identify and analyze the performance of outpatient clinics and inpatient facilities, schools EMC.

 

Theme 1. Organization of different types of treatment-prophylactic care for population. Outpatient care, inpatient and emergency care

 

Principles of treatment and prevention, inpatient and emergency care, the nature of the different species in the present conditions, the participation of health facilities at various levels in the health of the population.

Problems of outpatient, inpatient and emergency care.

The role of different health care settings and their interaction in the provision of primary, secondary and tertiary care.

The role of outpatient clinics in the health care providing individuals the impact of their work on health indicators and operation of hospitals , the need for an ambulance , the assessment of the performance of the health .

Prevention and outpatient clinics.

Clinical method, its principles, stages of clinical examination.

Interaction of clinics with the structures of family medicine.

The system inpatient care given the level of state aid. Features a modern hospital. Multiple and specialized hospitals, dispensaries.

Ensuring continuity between the clinics and hospital.

Management manages our beds.

Protecting the rights and safety of patients.

 

Theme 2. Organization and content of work of out-patient establishments of different levels, accounting and analysis of their activity.

 

            Tasks and sections of clinics, its structural units. Established standards.

         Functions of the major divisions.

         The organization and content of the district physician, head of department (office ).

         Objectives and nature of clinical methods , selection of contingents to follow-up .

         Types checkups and their organization.

         Stages of clinical examination .

         Basic documentation used to account for the work units clinic, content and procedure of filling:

Method of calculation and analysis of the performance of the clinic according to the report, health care setting (f № 20), report the number of cases reported in patients who live in the area of service health care setting (f. № 12).

         Development activities and improvement of outpatient clinics.

 

Theme 3. Organization and content of work of in-patient establishments of different levels, accounting and analysis of their activity.

 

Task hospitals.

Subdivisions hospital and their functions.

Procedure for referral of patients to hospital.

The content and organization of doctor-intern and the head office.

Factors affecting the sustainable use of bed numbers and efficiency of the department.

Basic documentation used to account for the work of a hospital, the content and order of its filling.

Method of calculation and analysis of the performance of the hospital according to the report, health care setting (f. № 20).

Development of measures to improve the activities of hospitals .

 

Theme 4. Organization and content of work of in-patient type establishments.

 

Types of day-care institutions.

The task structure day-care.

Features day-care home and hospital.

Procedure for referral to day hospital patients and hospital at home.

Basic registration of documentation day-care hospital and at home, the order of its filling.

Method of calculation and analysis of the performance of the day-care hospital and at home.

 

Theme 5. Family medicine and its value in the system of medical care.

 

The essence of the concept of ” primary care ” ( PHC ).

The role of PHC in ensuring the right to health.

The principles of PHC on the basis of family medicine.

Conditions and basic principles of PHC .

The role of the family doctor ( general practitioner ) to ensure the health needs of the population.

Models of family doctor, their essence, the problem of choosing a particular model.

The organizational model of transition from precinct and territorial public health care system in family medicine opportunities and feasibility of different models.

Problems and prospects of development of family medicine in Ukraine.

 

Theme 6. Content and organization of work of family doctor (general practitioner).

 

Organization of work of family doctor, provided its implementation based on different models.

Function and content family doctor regarding preventive, diagnostic, therapeutic measures addressing medical and social problems of the family.

Cooperation Organization of Family Physicians of Service paramedics and social workers.

Basic registration documentation institutions that operate on the principles of family medicine.

Identification and evaluation of the activities of family physicians.

 

Theme 7. Organization of medical care for the rural population and prospects of its development.

 

Features of medical support in rural areas. Stages of medical care to the rural population . The essence of stages.

The impact of natural and socio -economic conditions, the state of demographic processes, morbidity and disability organization Prophylaxis.

The problem of staffing the medical facility staff to rural medical stations.

Health care setting various stages of care and their job.

Organization of outpatient and inpatient care to residents living in the rural districts.

The essence of organizational and methodological and analytical work of district and regional hospitals.

Features Ambulance for rural population.

 

Theme 8. Organization of work of treatment-and-prophylactic establishments at different stages of medical care to rural population.

 

Functions and structure of rural medical facilities district.

Possible formation of the network of rural medical stations.

Features of the structure of the Central Regional Hospital ( CRH ) and its objectives.

Organization of specialized medical care to the rural population to the hospital.

Objective Regional Hospital , especially its structure and activities of clinics and hospital .

Determining the appropriateness of the location of the relevant health care institutions of different stages.

Identification and evaluation of the health of the rural population and to medical institutions in different stages.

 

Theme 9. Organization of emergency medical care (EMC). Content of work of EMC, accounting and analysis of its activity.

 

The value of emergency care (EMС) and its institutions. Task station (branch) emergency care (EMD) and its functions.

Collaboration with service EMD structures of the Ministry of Emergency Situations.

Structure EMD big city stations, types of field teams, their composition, functions.

Organization of EMD in the countryside.

Interaction with service EMD various medical institutions.

The records of stations EMD, definition and analysis of their activities.

 

Content module 5

Features of medical welfare for elderly population.

 

SPECIFIC OBJECTIVES:

• analyze the health of the elderly;

• explain the features of medical support older people;

• know the organization of geriatric care in some countries and Ukraine.

 

Theme 1. Organization of medical care for elderly population.

 

·        Medical and social significance of an aging population.

·        The impact of population aging on the demographic burden on public health and the need for medical support.

·        Peculiarities of the health of the elderly, special performance of their health.

·        Method of determination and evaluation of the health of older people.

·        The system of geriatric care in Ukraine (out-patient, stationary institutions). Tasks and prospects of its development.

Interaction geriatric care facilities with the structures of family medicine

Content module 6

Insurance medicine. Medical insurance.

 

SPECIFIC OBJECTIVES:

• interpret the term “health insurance” and “medical insurance”;

• explain the nature of compulsory and voluntary health insurance;

• interpret the purpose of health insurance and the main features of the system;

• know the components of health insurance, duties and rights of subjects of insurance;

• explain the features of insurance risks;

• know the history of health insurance in Ukraine;

 

Theme 1. Organizational principles of implementation and operation of health insurance.

 

The concept of health insurance is its purpose.

Contents of insurance.

Features of compulsory health insurance, members of the implementation of its basic programs , sources of funding.

Features of voluntary health insurance funding sources.

Organization of quality control of health services for different types of insurance.

Duties of insurers and policyholders.

The rights of the insured.

The economic essence of insurance medicine.

Types of insurance risks.

Features of health insurance in some countries ( Germany, France ).

Problems of implementation of health insurance in Ukraine.

 

Module 2.

ORGANIZATION OF SEPARATE TYPES OF MEDICAL CARE, EXAMINATION OF WORKING ABILITY. MANAGEMENT OF THE HEALTH CARE SYSTEM.

 

Content module 7

Health care for mothers and children..

 

SPECIFIC OBJECTIVES:

• know the definition of health of mother and child, its components;

• explain the importance of gender equality;

• understand the main point of the Law of Ukraine “On Ensuring Equal Rights and Opportunities for Women and Men (2005)

• interpret the legal bases of protection of motherhood and childhood, that public legal acts with international standards;

• interpret the nature of reproductive health;

• know the fundamentals of medical support for women and children;

• know the organization and content of the maternity hospitals, children’s hospitals;

• be able to fill out basic accounting records of maternity homes, children’s hospitals;

• identify and analyze the performance of maternity and children’s hospitals;

• interpret the essence of the state program “Reproductive Health of the Nation, 2006-2015.”

 

Theme 1. Medical and social problems of medical care for mothers and children. Reproductive health.

 

Place and role of maternity and child playing in generations.

Legislation for the protection of motherhood and childhood. Gender equality.

Features of the health of women and children. Reproductive health and the dynamics of its key indicators.

The value of the socio- economic, socio- psychological, medical and social measures aimed at improving the health of women and children.

Types of institutions to provide different types of care ( health care , recreational , educational ).

Centers for women’s health.

Health- care facilities providing obstetric care, especially their formation in urban and rural areas.

Organization of medical and preventive care for children, especially the provision of specialized care.

National and regional programs for improving the health of women and children, the value of complexity in their implementation. State Program “Reproductive Health of the Nation, 2006-2015 .”

 

Theme 2. Organization and content of work of maternity hospitals, accounting and analysis of their activities.

 

Objectives and content of prenatal and its structural units. The functions of the various medical facilities in respect of antenatal fetal health.

Peer review of organizational elements of health of pregnant women and gynecological diseases.

The challenge of work -patient hospital, especially its structure, interaction with prenatal, children’s clinics, orphanages.

Basic registration documentation the hospital. The content and order of its filling , the possibilities of use.

Method of calculation and analysis of the performance of the hospital for a report on health care for pregnant women, women and mothers (f. № 21).

Development of measures to improve the activity of the hospital.

 

Theme 3. Organization and content of work of children’s hospitals, accounting and analysis of their activities.

 

The objectives and content of the children’s clinic and its structural units.

Preventive and anti-epidemic work child health clinics.

The content and organization of the district pediatrician.

The essence of follow-up for children’s health, expert assessment of its completeness.

Organization of specialized health care for children .

The organization of medical care in pre-schools and schools.

Basic registration records of children’s hospitals, the content and the procedure for filling the possibilities of use.

Method of calculation and analysis of the performance of the children’s hospital , according to a report on health care for children (f № 31 health ).

Developing measures improvement of children’s hospitals.

 

 

Content module 8

Medical and social aspects of examination of loss of working ability.

 

SPECIFIC OBJECTIVES:

• interpret the types of medical examinations;

• interpret the legal basis of the medical examination;

• explain the purpose of medical and social assessment of disability;

• interpret the concept of temporary and permanent disability;

• explain the impact of various factors on the origin of the formation of temporary and permanent disability;

• analyze the development and examination of the state of efficiency;

• know the organization of the medical examination of temporary and permanent disability;

• know the basic rules of design documents.

 

Theme 4. Organization of medical examination of disability, its legal basis. Medical and social aspects of disability.

 

Types of medical examinations, their task.

The essence of medical and social examination of temporary and permanent disability.

Degree of disability.

Establishments engaged the expertise of temporary disability, their task.

Types of temporary disability, especially in the examination of certain types of disability.

Organization expertise disability. Types of disability.

The main causes of disability. Factors that affect it.

Group disability. Indicators of disability.

Major trends in indicators of disability in Ukraine.

The essence and meaning of the law “On the Rehabilitation of the Disabled in Ukraine” (2005).

 

Theme 5. Methods of medical examination.

 

Peculiarities of the examination of medical and social disability and expertise: military-medical, forensic and forensic psychiatric, pathological–anatomical and legal principles.

The purpose of the various types of medical examination bodies and institutions that carries it.

Responsibility Physicians medical and other facilities for medical examination.

 

Theme 6. Content and methodology of medical examination of temporary disability, ways of its implementation.

 

The task of physicians during examination of temporary disability.

Medical Consulting Committee ( MCC ): function , structure, organization of work.

The content, purpose and procedure for filling the records are used for the examination of temporary disability.

Values of medical certificate as accounting, legal and financial documents.

Determination of different tactics officers of health care settings and on specific types of cases of temporary disability.

Making sick leave in certain types of cases, and temporary disability.

 

Theme 7. Organization of medical examination of disability.

 

The task of physicians, medical advisory committees concerning examination disability.

Medico-Social Expert Commission (MSEC), their types (for administrative-territorial basis, with profiles).

Features of MSEC.

The content, purpose and procedure of filling the main document disability used in the examination.

Identification and assessment of MSEC tactics regarding installation causes and disability groups in some of its forms.

Identification and evaluation of disability.

 

Content module 9

Problems of assessing the quality of medical care.

 

SPECIFIC OBJECTIVES:

• interpret the concept of “quality of medical care“

• explain the nature of the components of quality of care;

• analyze the applicability of intermediate and long-term indicators of quality of medical support;

• describe the types and content of performance standards in health care;

• know the essence of the model final results (MFR) health facilities;

• identify MFR individual health care institutions;

• analyze the meaning and essence of expert assessments of health of the population.

 

Theme 8. Essence and features of quality of medical care. Formation of different kinds of care quality standards.

 

Basic concepts and terms of quality of care.

Components of quality: structural quality, the quality of technology, the quality of results.

Methods of assessing quality. Requirements for methods: suitability for use on different stages and types of care , fairness , opportunity quantitative estimates essentially correct display of medical practice.

Indicators of the quality and effectiveness of care.

Quality standard of care regarding DRGs , nosological forms.

Standards of medical technologies. The use of clinical protocols.

Medical and economic standards.

Intermediate and long-term indicators of quality of care.

The value of the licensing and accreditation of health facilities to ensure quality of care.

 

Theme 9. Methods of medical assessments of particular groups of the population.

 

         Types of control medical activities.

         The value of peer reviews to features of the diagnostic and treatment process.

         The organization of expert evaluation of medical institutions and their departments and medical staff.

         Development of questionnaires to assess various types of medical practice.

         Method of determining the level of quality of treatment outcomes models , the integral coefficient of efficiency.

         The essence of expert assessments meet the public health provision.

         Methods of medical and sociological research, its importance for the development of an effective control system.

 

Content module 10

Organization of sanitary and epidemiologic care for population.

 

SPECIFIC OBJECTIVES:

• interpret the term ” sanitary and epidemiological welfare of population” ;

• explain the importance of legal principles of the State Sanitary and Epidemiological Surveillance ;

• characterize the nature of the activities of health service ;

• know the structure of the SES ;

• explain the particular structure of the sanitary- epidemiological stations (SES) , depending on the levels of government ;

• describe the content and organization of medical hygienists and epidemiologists ;

• interpret the nature of the powers of officials to implement SES state sanitary and epidemiological supervision;

• know the types of administrative acts in the activities of SES ;

• interpret the rights and obligations of enterprises , institutions , organizations and individuals related to sanitary and epidemiological welfare of the population;

• describe the responsibilities of SES and health care institutions ( hospitals) regarding implementation of preventive and anti-epidemic measures;

• determine the nature of action SES and health facilities during the preventive measures.

 

Theme 10. Organization of sanitary-epidemiological service. Legal basis of sanitary-epidemiological service.

 

The value of SES in ensuring sanitary and epidemiological welfare of the population.

The legal basis for SES : Basic Law of Ukraine on Health (1992 , Project 2005) , the Law of Ukraine on Ensuring Sanitary and Epidemiological Well-Being (1994 ), the Law on the Protection of the Population from Infectious Diseases Regulations on state sanitary epidemiological surveillance ( 1999), Statement on the State sanitary and Epidemiological Service ( 2004).

Areas of activity SES .

The content and scope of activities of SES, depending on the levels of government.

Methods of doctors hygienists and epidemiologists:

The essence of preventive and current state sanitary and epidemiological surveillance.

Powers of chief public doctors and other officials of the state sanitary and epidemiological service.

The rights and obligations of enterprises, institutions , organizations and individuals related to sanitary and epidemiological welfare of the population.

Types of liability for violations of sanitary laws.

 

Theme 11. Organization of work of sanitary-epidemiologic establishments. Co-operation of sanitary-epidemiologic service and treatment-prophylactic establishments (TPE).

 

The content and organization of different SES levels of government.

Structure SES district, city , regional .

SES staffing the various levels of government.

Nature and the interaction of different departments and the health care system to ensure healthy living and working conditions .

Contents of sanitation and health care institutions regarding primary prevention of methodological support .

Responsibilities of SES and PSI regarding the implementation of preventive measures.

Determining the feasibility of actions SES and PSI regarding anti activities .

Types of administrative regulations to implement the Surveillance , the order of their application.

 

Content module 11

Basics of management. Management in health care.

 

SPECIFIC OBJECTIVES:

 

• explain the control laws;

• interpret management principles;

• interpret the meaning of various management regulations in the health care system;

• explain the features of management in health care;

• interpret the essence of control and the components of the management process;

• analyze factors that influence the effectiveness of management in health care.

 

Theme 12. Fundamentals of health care management.

 

The subject of management science. The laws of science and management complexity of their application.

Management principles, the nature of objectivity, specificity, systemic, sectoral and territorial management, planning, allocation of main level.

The main methods of management science.

Components of the system: the system-component, functional, structural, integrative, communication, history.

Features of the health care system.

Factors affecting the efficiency of health care management: improving the selection of management personnel, scientific improvement of work style management personnel, scientific organization of labor in the rulers and the ruled subsystems, advanced functions and management structure.

Components of the management process: the development and management decisions to organization system of regulation and control of the implementation of decisions.

The role of the manager in the health care system.

Management organization of health care system in Ukraine.

 

Theme 13Methods of decision-making. Personnel management.

 

The essence of different management regulations in the health system.

Management decisions in the work of the major health care institutions and their departments.

Method development and management decisions on the organization of health care and health care settings.

Features of administrative decisions with regard to social and psychological backgrounds of the team.

 

Content module 12

Forming of healthy way of life.

 

SPECIFIC OBJECTIVES:

• interpret the impact of lifestyle factors on health;

• analyze the features of a healthy lifestyle in some populations;

• explain the interaction of health care services and various agencies in promoting healthy lifestyles;

• know the methods and hygiene education of the population;

• evaluate the role of health centers in the formation of a healthy lifestyle.

 

Theme 14. Organization, methods and means of hygiene training and education of the population.

 

The value of a healthy lifestyle for maintaining and promoting health .

Leading factors of lifestyle that affect the health status of the population.

Areas of healthy lifestyle .

Health care institutions, agencies and services that are involved in the formation of a healthy lifestyle.

The objectives and content of the health centers and their interactions with health care providers.

Main areas of health and hygiene education in various health care facilities.

Methods and tools for health and hygiene training and education of the population and their characteristics.

Development of questionnaires to explore the various factors that affect the health of the population.

Plan of lectures and training relevant abstracts.

 

 

4. The structure academic discipline

 

 

 

5. Themes of Lectures

 

 

6. Themes of Seminar Classes – not applicable

 

 

7. Themes of Practical Classes

 

 

8. Themes of Labs – not applicable

 

 

9. Self-Study

 

 

10. Individual work – not applicable

 

 

11. Teaching Methods

According to sources of knowledge, the following teaching methods are used: word – narration, explanation, lecture, briefing, visual – demonstration, illustration, practical – practical work tasks.

According to the nature of the logic of knowledge, the following methods are used: analytical, synthetic, analytical-synthetic, inductive, deductive.

In terms of individual mental activity, the following methods are used: problematic, exploration, research.

 

 

12. Methods of Evaluation

Forms of Testing and Evaluation

In evaluation of students’ knowledge, standardized methods of evaluation are primarily used: test (oral, written, computer-based), structured written work, structured monitoring of practical skills.

Subject grade is defined as the two modules grade according to the course structure.

Assessment for the module is the sum of daily grades and evaluation of the final module test and based on 200-point system.

Forms of evaluation

Daily evaluation is performed each class for specific topics. At all classes, objective evaluation of theoretical knowledge and practical skills is done.

Forms of daily evaluation:

Theoretical knowledge – tests, computer-based tests, individual surveys, interviews, written work.

Practical skills – independent individual tasks and the ability to draw conclusions on their own ability to perform certain transactions, writing schemes and algorithms. Final test is based on theoretical knowledge, practical skills and abilities.

Final test of the module takes place at the end of study of the relevant content modules in the form of a test and is considered passed if the student scored at least 50 points.

Forms of final test:

Theoretical knowledge – a system of questions for written and computer-based testing.

Practical skills and ability – using basic methods of medical statistics in conducting and evaluating biomedical researches taking into account the main provisions of evidence-based medicine, a comprehensive assessment of health in relation to social and environmental factors in determined area; identification and analysis of key performance indicators of health care establishment on the basis of situational problems.

 

 

13. Distribution of points received by students

Maximum number of points assigned to students in mastering the module (test credits) – 200, including daily scores – 120 points, results of final module test – 80 points.

Evaluation of daily training:

At each stage of a practical class (practical, seminar, written test) students are assigned rating in the 12-point scale. Then arithmetic mean of the three evaluations is derived and noted in the register.

For each phase of the practical part of a class, students get points as follows:

1. At the beginning of the practical part, students must qualify for practical work (they must know the process of practical work, etc.). For this stage students can get a maximum of 2 points.

2. Practical work is monitored by the teacher and assessed at the end. Students can get a maximum of 4 points for this type of work.

3. Defense of practical work. At this stage, students can receive a maximum of 6 points.

At the end of practical part, the teacher calculated the mean of the scores for each part of the class and notes it down for each student.

 

DISTRIBUTION OF POINTS RECEIVED BY STUDENTS

 

DISTRIBUTION OF POINTS RECEIVED BY STUDENTS

 

 

The minimum grade point average that qualifies a student to take final module test – 4 points.

The maximum points that can be earned by a student during module is 120 points.

 

Final module test:

Final module test is taken at the end of a module. Students who have completed all work stipulated by the curriculum and whose score for the module reached the minimum, qualify for the final test.

The final evaluation should be standardized and include testing in theoretical and practical training. Specific forms of evaluation for the Social medicine and organization of health care are stated in the syllabus.

The maximum of final test points is 80.

The final module test is passed if a student scores at least 50 points.

Grades for the subject:

Grades for the Social medicine and organization of health care are received only by students who have completed all modules in the discipline.

The number of points that a student earns for the discipline is defined as the average of points for the modules of the discipline and for the final test of Module 1.

Objectivity of assessment of students must be checked by statistical methods (correlation between the current progress and results of the final module test).

Conversion of points for Social medicine and organization of health care into grades according to the ECTS scale and 4-point scale (traditional)

Number of points that a student gets for a discipline is converted into the ECTS scale as follows:

Percentage of students is determined out of students of the same year of study within the same specialty.

Number of points for a discipline earned by a student is converted into 4-point scale as follows:

 

FX and F (“2”) score for a discipline is assigned to a student who has not passed at least one module of the discipline.

FX (“2”) score is assigned to students who earned the minimum number of points for daily academics, but have not passed the final module test. They have the right to repeat the final module test up to 2 times during winter break or in two (additional) weeks after the end of the spring semester schedule approved by the Rector.

Students who received an F score after completing the course (have not completed the program of at least one module or have not earned the minimum number of points in the current module) must undergo re-training according to the individual curriculum.

 

Grading scale: national and ECTS

 

 

14. Methodological Support

1.       Materials for the practical classes

2.       Materials for the lectures.

3.       Presentations of lectures.

4.       Guides for practical classes.

5.       Tasks for self-study and individual work of students.

6.       Tests for the final evaluation.

7.       Tests for daily evaluation.

8.       Variants of theoretical questions for self-study.

 

 

15. Suggested Reading

Basic

1. O. Holyachenko, A. Shulhai, O. Nykytyuk. Social medicine and health protection organizations. – Ternopil, “Ukrmedknyga”, 2004. – 171 p.

2. Matthew R. Anderson, Lanny Smith, and Victor W. Sidel. What is Social Medicine? Monthly Review: 56(8).

3. Henderson G, King NMP, Strauss RP, Estroff SE, Churchill LR (2007) The social medicine reader. 1st edition. Durham: Duke University Press.

4. Irwin A, Valentine N, Brown C, Loewenson R, Solar O (2006) The Commission on Social Determinants of Health: Tackling the social roots of health inequities. PLoS Med 3: e106.

5. Henderson GE, Estroff SE, Churchill LR, King NMP, Oberlander J, et al. editors (2005) Social and cultural contributions to health, difference, and inequality. Volume II: The social medicine reader 2nd edition Durham: Duke University Press.

6. Oberlander J, Churchill LR, Estroff SE, Henderson GE, King NMP, et al. editors (2005) Health policy, markets, and medicine. Volume III: The social medicine reader 2nd edition Durham: Duke University Press.

 

Additional

1. Waitzkin H, Iriart C, Estrada A, Lamadrid S (2001) Social medicine then and now: Lessons from Latin America. Am J Public Health 91: 1592–1601.

2. Campbell, D. T. (2008). Methodology and epistemology for social science: Selected papers. Chicago: University of Chicago Press.

3. Clinton, J. (2002). Ethnicity: The development of an empirical construct for cross-cultural health research. Western Journal of Nursing Research, 4(3), 281-300.

4. Dibble, S. L, Bostrom-Ezrati, J., & Rizzuto, С (2000). Clinical predictors of intravenous site symptoms. Research in Nursing and Health, 14, 413-420.

5. King NMP, Strauss RP, Churchill LR, Estroff SE, Henderson GE, et al. editors (2005) Patients, doctors, and illness. Volume I: The social medicine reader 2nd editionDurham: Duke University Press.

6. Rodgers A, Ezzati M, Vander Hoorn S, Lopez AD, Lin RB (2004) Distribution of major health risks: Findings from the Global Burden of Disease study. PLoS Med 1: e27.

 

16. Information Resources

1.                 Prabhakara. Short Textbook of Preventive and Social Medicine. – Jaypee Brothers Publishers

2.                 Practical classes materials

3.                 Lecture materials