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57 Cards in this Set
- Front
- Back
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What do you understand by taking a population perspective?
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Complements the focus on the individual.
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What may be a problem with a population perspective?
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Sometimes the interests of the individual and the population conflict.
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In what ways may understanding the health of a population influence the practice of a doctor?
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Understand what causes disease, know what works in terms of treatment, and improve health.
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Define health.
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Homeostasis. A state of balance, with energy inputs and outputs in equilibrium.
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What is the WHO's definition of health?
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A state of complete physical, mental and social well-being, and does not only consist of absence of disease.
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What is the problem with the WHO's definition of health?
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It's idealistic and unrealistic and would mean 70-95% of people would be classed as unhealthy.
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What is incidence?
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The number of new cases within a time period divided by the size of the population initially at risk.
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What is prevalence?
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The total number of individuals with a disease at a particular time divided by the total population at risk.
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What are the three major causes of ill health in adults in the UK?
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Circulatory disease, respiratory disease and cancer.
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What are the four major causes of ill health in children in the UK?
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Infection, injury, poisoning and cancer.
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Give five of the major causes of ill health in the developing world.
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Cholera, malnutrition, malaria, AIDS and diarrhoea.
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Give four factors that lead to the changes in life expectancy in the developed world over the last century.
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Safer water and sewers, better nutrition, immunisation and control of disease-bearing insects and rodents.
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What is a population pyramid?
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Two back-to-back bar graphs, one showing the number of males and one showing females in a particular population in five-year age groups.
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What are the two basic shapes of population pyramids?
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Triangular population distribution and rectangular population distribution.
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Give two other possible names for the triangular distribution.
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Pyramid or exponential distribution.
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What does the large base indicate on a triangular distribution?
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Large number of children.
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What does the rapid narrowing show on a triangular distribution?
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Many people die between each age band.
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What three things can be concluded from a triangular distribution?
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High birth rate, high death rate, and short life expectancy.
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What is the usual type of country for a triangular distribution?
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A less economically developed country.
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Why are there usually more females than males in a triangular distribution?
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Because females have a greater life expectancy.
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What does the narrow base of a rectangular distribution show?
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Relatively few children and young people.
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What does lack of change in size between consecutive age groups in a rectangular distribution show?
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Very few people die until they reach old age.
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What type of country is shown by a rectangular distribution?
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More economically developed country.
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Why is the base of the pyramid sometime narrower than the middle on a rectangular distribution?
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Falling birth rate.
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How is stillbirth rate calculated?
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Number of infants stillborn with a gestational age of al least 24 weeks per 1000 total births.
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How is neonatal mortality rate calculated?
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Number of deaths within the first 28 days per 1000 live births.
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When is the time of early neonatal?
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First seven days of life.
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When is the time of late neonatal?
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7-28 days.
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How is perinatal mortality calculated?
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Number of stillbirths and deaths within the first 7 days of life per 1000 births.
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How is infant mortality calculated?
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Number of deaths within 1 year of life per 1000 live births.
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How do fertility rates in developed and developing worlds compare?
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Fertility is higher in the developing world.
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Give four ways EBDM is implemented.
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Evidence based clinical guidelines, summaries of evidence provided for practitioners, access to reviews of research evidence and practitioners evaluating research for themselves.
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What are the four forms of information doctors have to bring together to carry out their work?
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Evidence from research, clinical experience, available resources and patient preferences.
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What is meant by the term evidence?
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An observation, fact or organised body that is offered to support beliefs by demonstrating an issue.
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Give five reasons why EBDM is important.
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Medical knowledge is incomplete, medical knowledge is always shifting, government initiatives eg NICE and CHI, constant need for improvement and needs to be central to current healthcare policy.
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Give two ways in which uncertainty may be a problem.
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Diagnosis and treatment.
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How could diagnosis be uncertain?
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A diagnostic test won't identify everyone with or without a particular disease, and it's hard to know how a patient will react to intervention.
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How could treatment be uncertain?
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Variation in how different clinicians carry out different procedures.
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Give three things that primary care trusts do.
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Improve the health of the community, integrate health and social care locally and contract services from "independent contractors" eg GPs, dentists and pharmacists.
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How many people does each primary care trust cover roughly?
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170,000.
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What do each strategic health authority do?
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Puts into place policies by the DoH in regional areas.
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What is a foundation hospital?
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A hospital trust free of direct governance from the DoH, and has considerable freedom of budget.
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What do acute and community NHS trusts do?
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Have considerable levels of freedom. They can make plans fro modernisation and have decisions over wages. Must be consistent with local authorities.
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Give two examples of acute NHS trusts.
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Hospitals and ambulances.
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Give an example of community NHS trust.
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Care trust with integrated health and social care.
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What three areas does NICE produce guidelines on?
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Use of health technologies, clinical practice and guidance for public sector workers on Health promotion and ill-health avoidance.
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What does the healthcare commission do?
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It's an independent body set up to inspect the quality of NHS services and make public reports.
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Give two things that healthcare commission looks into.
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Implementation of NICE guidelines and local clinical governance.
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What three things are charged for in the NHS?
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Prescription charges, dental care and ophthalmic care.
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Where does most of the finance come from for the NHS?
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Taxes - 85%, NI contributions - 10% and user charges - 5%.
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How is healthcare paid for in the USA?
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By taxation but only for the poorest and the elderly, the rest through private insurance.
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How is healthcare paid for in Germany?
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Social insurance.
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How is healthcare paid for in Italy?
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Mostly state provided, but charge €50 for operations etc.
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How is healthcare paid for in France?
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Pay for your own medical care, but then some or all of it is refunded.
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Give three uses of the GMC.
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Controls UK medical register, sets standards across healthcare and continues to revalidate doctors.
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Who is responsible to the GMC?
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All medical students and doctors.
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What sanctions can the GMC apply?
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Warning, conditions of license, suspension and removal from register.
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