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19 Cards in this Set
- Front
- Back
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Define: • Need • Demand • Supply • Health needs assessment • Healthcare need • Felt need • Expressed need • Normative need • Comparative need |
• Ability to benefit from an intervention • What people ask for • What is provided • Systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities • More specific need for a particular service that will provide a benefit for that individual • Individuals perception of variation from normal health • Individual seeks help to overcome variations in normal health • Professional defines intervention appropriate for the expressed need • Comparison between severity, range of interventions and cost |
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What are the 4 steps of needs assessment cycle? |
Assessment -> Planning -> Implementation -> Evaluations |
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Describe the three public health approaches |
• Epidemiological - Define problem size, services available, look at evidence base • Comparative - Compare services received between groups • Corporate - Ask population, commissioners, providers, patients, politicians |
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What are the 9 types of error? |
• Sloth • Fixation / loss of perspective • Communication breakdown • Playing the odds • Bravado • Lack of skill • System error • Ignorance • Mis-triage |
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Why can errors occur? |
• System failure • Human factors • Judgement failure • Neglect • Poor performance • Misconduct |
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What 4 questions must be asked in cases of neglect? What two principles also must be looked at? |
• Was there a duty of care? • Was there a breech in this duty of care? • Did the patient come to harm? • Was the hard due to the breach in care? • Bolam - Would a group of reasonable doctors do the same in this situation? • Bolitho - Would this be a reasonable thing for them to do? |
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What is a "never event"? |
Serious, largely preventable patient safety incidence that should not occur if the available preventative measures have been implemented. Intolerable and inexcusable. |
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Define: • Incidence • Prevalence • Sensitivity • Specificity • Positive predictive value • Negative predictive value |
• The number of new cases arising in a given population during a specific time period • The number of existing cases in a population at a specific point in time • The proportion of people that have a condition that test positive for that condition (A / A+B) • The proportion of people that don't have a condition that tested negative for the condition (D / D+C) • The probability that a person has a condition given a positive test result (A / A+C) • The probability that a person does not have a condition given a negative test result (D / D+B) |
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How do you calculate: • Relative risk • Attributable/absolute risk • Absolute risk reduction • Number needed to treat • Odds |
• RR = risk exposed / risk unexposed • AR = RE - RU • ARR = RU - RE • NNT = 1 / (RE - RU) • Odds = cases / non-cases |
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What are the main types of errors in studies?
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• Bias - selection or information • Chance • Confounding factors (a factor that is associated with both the exposure and the outcome but is not on the causality pathway between them) • Reverse causality |
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What are the Bradford-Hill criteria for causality? |
• Temporality - Exposure must have occurred before the outcome • Dose response - increasing the exposure increases the severity / onset of the outcome • Strength - High relative risk • Reversibility - Removing / reducing exposure reduces the risk of the outcome • Consistency - Study is reproducible |
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What are the WHO criteria for a screening programme? |
Condition
• Important health problem • Detectable latent / early phase • Natural history of condition should be well known / understood Method • Suitable method of detection • Acceptable to the population Treatment • Suitable treatment should be available • Early intervention should be more effective Programme • Cost effective • Agreed policy on who to treat • On-going programme |
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Define: • Length time bias |
• Early detection gives false impression that survival is longer when actually has no impact on prognosis • Screening is more likely to detect slow growing illnesses with better prognoses |
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Define: • Health improvement • Health protection • Improving services |
• Societal interventions aimed at preventing disease, promoting health and reducing inequality • Measures to control infectious diseases and environmental hazards • Organisation and delivery of safe, high quality services for prevention, treatment, and care |
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Define: • Health behaviour • Illness behaviour • Sick-role behaviour |
• A behaviour aimed at promoting health eg eating healthily • Aimed at seeking a remedy to an existing illness (expressed need) • A behaviour aimed at getting well eg taking medication |
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What are the theories of planned behaviour? |
• Transtheoretical model (stages of change) • Motivational interviewing • Nudge therapy |
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What are the stages of change |
Pre-contemplation ->contemplation -> preparation -> action -> maintenance -> graduation or relapse |
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What makes a disease a public health concern? |
• High mortality • High morbidity • Highly infectious • Expensive to treat • Effective interventions are available |
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What are the steps of hierarchal need? |
(Top) Self actualisation Esteem Love/belonging Safety Physiological (bottom) |
