Calculation of total incidence formula. Health of the population of Russia. Morbidity

Morbidity I Morbidity

the most important indicator of the state of public health, characterizing the prevalence, structure and dynamics of diseases registered by doctors among the population in or in its individual groups (age, gender, territorial, professional, etc.) and serving as one of the criteria for assessing the work of a doctor, medical institution, health care authority.

Like an object scientific research and practical activities of healthcare institutions and bodies represents complex system interrelated concepts: morbidity itself (primary morbidity) - a set of new diseases that have not been taken into account anywhere before and were identified among the population for the first time in a given calendar year; (prevalence of diseases) - the totality of all diseases existing among the population, both first identified in a given calendar year, and registered in previous years, for which patients again sought medical care in given year(accumulated morbidity); the frequency of pathology among the population, established during one-time medical examinations (examinations), during which all diseases, as well as premorbid forms and conditions, are taken into account. In this case, two indicators are determined: incidence (incidence) - the frequency of newly emerging diseases, and prevalence (prevalence) - the prevalence of all diseases existing among the population.

Data about health is collected, processed, analyzed and evaluated using special methods and techniques developed by medical statistics (Medical statistics) . Completeness and reliability of information about each a separate disease, and therefore, the morbidity of the population as a whole depends primarily on the doctor who identifies, diagnoses and registers cases of diseases in the prescribed manner, as well as on the medical statisticians involved in processing the data obtained. Z. is determined based on data on the population’s requests for medical care; according to medical examinations and in-depth examinations; according to medical reasons of death. In addition, health is studied based on information about the temporary disability of workers and employees, according to data on hospitalized patients, and according to population surveys about the state of health and the presence of diseases. Each of the methods has its own source of information, primary statistical accounting document, analysis (generalizing and evaluative medical-statistical indicators, medical-statistical, diagnosis and prognosis).

The most complete and accurate data on health can be obtained by conducting specially organized, most often selective, medical-statistical and epidemiological studies, as well as on the basis of reliable records of data from visits to doctors in outpatient clinics. Based on a complete record of diseases registered when visiting doctors, the general health of the population is studied. In this case, the unit of accounting is the first visit to a doctor for a given disease in a given calendar year ( acute diseases are registered with each new occurrence; chronic ones are counted only once a year).

To optimize the study of morbidity, the Ministry of Health of the USSR introduced a unified continuous recording, primary statistical processing and analysis of information on all cases of diseases for which people seek medical care and which are identified during medical examinations and in-depth examinations. The availability of such information is necessary for carrying out current and future organizational and medical measures aimed at combating diseases. For this purpose, special accounting of infectious (epidemic) morbidity is carried out: all quarantine diseases (plague, cholera, yellow fever); diseases, each case of which is reported to the local authorities with detailed information about the patient (paratyphoid fever and other salmonellosis, enteritis, whooping cough, encephalitis, scarlet fever,); other diseases about which treatment and preventive institutions provide only summary information to the SES (, acute respiratory viral infections and etc.).

Along with taking into account acute infectious diseases, special accounting is also carried out for a number of non-epidemic diseases and occupational diseases, in which the frequency of spread, severity of outcomes, and social characteristics are analyzed. In the USSR, tuberculosis, mycoses, trachoma, malignant neoplasms, mental and some other diseases.

The incidence of morbidity with temporary loss of ability to work (morbidity of working contingents) is subject to special recording and analysis. Official temporary disability due to illness is administered by trade union bodies and is widely used in healthcare. The unit of accounting is a case of incapacity for work due to a disease (exacerbations of one chronic disease can result in several cases of loss of ability to work during a calendar year), and the accounting document is a Certificate of Incapacity for Work. . Especially great importance in the analysis of this type of labor, they have data on the influence of specific working and living conditions of workers on its level, structure and dynamics in real conditions place and time. The development of source materials should be carried out for various groups and categories of workers, taking into account profession, gender, age, etc. The main task of the analysis should be the development of measures to reduce the incidence of illness among workers in each specific workshop, site, and enterprise as a whole.

An important place is given to the analysis of the so-called hospitalized morbidity. Information about hospitalized patients is widely used for planning and organizing hospital care. The unit of accounting in this case is the case of hospitalization of the patient in, and the accounting document is statistical.

Morbidity detected actively during periodic medical examinations (in-depth examinations) is based on widespread use in the practice of medical and preventive institutions, the dispensary method of monitoring the health of various population groups: workers and employees of industrial and agricultural enterprises, adolescents, schoolchildren, etc. (see Medical examination) . Medical examination data have great diagnostic value, accuracy and reliability and make it possible to distribute the population into health groups (healthy, practically healthy, requiring medical supervision, inpatient treatment, surgical intervention and so on.).

With the introduction of general medical examination (Dispenserization) population, there is a real opportunity to obtain close to comprehensive data on the health of the population living in a certain territory. Combining all the information for each resident in one document or in the data bank of the information and computing center will make it possible to solve the problems of improving medical care for the population and planning its development for the future.

Reliable information about the size, nature, and dynamics of the population, incl. its individual groups are necessary to assess the state and trends of population health, the effectiveness of medical, hygienic and social measures carried out by the state, as well as for scientifically based planning various types specialized medical care, rational use and development of material, technical and human resources for healthcare (Healthcare) both at the Union and regional levels.

Bibliography: Dogle N.V. and Yurkevich A.Ya. Morbidity with temporary disability, M., 1984, bibliogr.; Merkov A.M. and Polyakov L.E. Sanitary statistics, L., 1974; Guide to social hygiene and healthcare organization, ed. Yu.P. Lisitsyna, vol. 1, p. 119, M., 1987; Sluchanko I.S. and Tserkovny G.F. Statistical information in the management of healthcare institutions, M., 1983; and health care organization, ed. A.F. Serenko and V.V. Ermakova, s. 230, M., 1984.

1. Small medical encyclopedia. - M.: Medical encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what “Morbidity” is in other dictionaries:

INCIDENCE- INCIDENCE, a term understood as an account of new, previously unregistered diseases in the population (or in its individual groups) and indicating the movement of phenomena, as opposed to the terms morbidity (see), pathological lesions, which speak of ... ... Great Medical Encyclopedia

INCIDENCE, the prevalence of diseases among the population or its individual groups; statistical indicator. Characterizes the health status of the population and is expressed by the number of registered diseases per 100, 1 thousand or 10 thousand people... ... Modern encyclopedia

Prevalence of diseases among the population or its individual groups; statistical indicator; characterizes the health status of the population: the number of registered diseases per 100, 1 thousand or 10 thousand population of a certain territory for... ... Big Encyclopedic Dictionary

INCIDENCE, morbidity, many. no, female (stat.). The emergence of diseases among the population; relative number of diseases. In autumn, the incidence of the disease in the population increases significantly. Childhood morbidity in cities is higher than in villages.... ... Dictionary Ushakova

Prevalence of diseases among the population or its individual groups; a statistical indicator that characterizes the health status of the population or the number of registered diseases per 100, 1 thousand or 10 thousand people. The main method... ... Dictionary of business terms

INCIDENCE, and, women. Number of diseases. Reduced morbidity. Ozhegov's explanatory dictionary. S.I. Ozhegov, N.Yu. Shvedova. 1949 1992 … Ozhegov's Explanatory Dictionary

English morbidity; German Krankenstand. An indicator of the health status of the population, calculated by the number of registered diseases per 100, 1000 and 10000 inhabitants in a certain territory for 1 year. Antinazi. Encyclopedia of Sociology, 2009 ... Encyclopedia of Sociology

The spread of diseases among the population and its individual groups. Statistically estimated by the number of newly identified and registered over a certain period of time per 1000, 10000 or 100000 people; indicator reflecting the level... ... Dictionary of emergency situations

A statistical indicator that determines the number of detected and registered diseases among people, animals, and plants over a certain period of time in a specific area. Ecological encyclopedic Dictionary. Chisinau:... ... Ecological dictionary

Disease - any subjective or objective deviation from normal physiological state body. The concept of “disease” is broader than the concept of “illness”.

Morbidity is complex indicator structure and quality of diseases, which shows the level and frequency of spread of all diseases taken together and each one separately among the population as a whole and in its individual age, social, gender and other groups.

Morbidity is studied according to the following indicators:

1) The actual incidence - first identified this year, not recorded anywhere before.

2) Morbidity - prevalence - the totality and frequency of all existing diseases, first identified in a given year and registered in previous years, for which patients returned again in the current year.

3) Pathological involvement - the frequency of diseases, which is established during medical examinations. Both functional and morphological disorders, which can lead to illness, etc.

Morbidity classification:

I. Uniformity of diagnosis and registration of all known nosological forms is achieved on the basis of the ICD - 10th International Classification of Diseases, in which all diseases are divided into 21 classes:

2. Neoplasms

3. Diseases endocrine system, immune system and metabolism

4. Diseases of the blood and hematopoietic organs

5. Mental disorders

6. Diseases nervous system and sense organs

7. Diseases of the circulatory system

8. Respiratory diseases

9. Digestive diseases

10. Diseases of the genitourinary system

11. Complications of pregnancy, childbirth, and the postpartum period

12. Diseases musculoskeletal system And connective tissue

13. Congenital anomalies and developmental defects

14. Certain conditions of the perinatal period

15. Skin diseases

16. Symptoms and ill-defined conditions

17. Poisoning injuries

18. Diseases of the eyes and appendages

19. Diseases of the ear and mastoid process

20. External reasons morbidity and mortality

21. Factors influencing the health of the population

All classes are divided into groups:

1.epidemiological diseases

2. constitutional and general diseases

3. local diseases (anatomical localization)

4. developmental diseases

II. Types of morbidity:

A) morbidity according to the data of visits to health care facilities

1. primary – diseases newly identified

2. general – the first appeal this year regarding this disease, chronic diseases are counted only once a year.

3. accumulated – all chronic diseases

B) incidence according to data medical examinations– pathological lesion

C) morbidity according to data on causes of death

2.By population:

A) occupational morbidity

B) morbidity with temporary disability

B) morbidity in pregnant women

D) morbidity among women in labor and postpartum

D) morbidity of children attending kindergartens

E) morbidity among schoolchildren

G) morbidity among military personnel, etc.

3.By age:

A) morbidity in children (newborns, preschoolers, schoolchildren)

B) morbidity among adolescents

B) morbidity in adults

4.By classes, groups of diseases, nosological forms:

A) infectious morbidity

B) incidence of the most important socially significant and dangerous diseases

B) cancer incidence

D) injuries, etc.

5.By gender:

A) morbidity in women

B) morbidity in men

6.At the place of registration:

A) outpatient clinic

B) hospitalized

Cases of any type of morbidity are recorded in special documents: call logs. outpatient cards, medical history, etc.

III. Statistical types:

1. General (visibility, medical examinations, causes of death) - calculated: primary morbidity, prevalence, frequency by age groups, duration, according to the severity of the disease.

Medical examinations:

1.preliminary – upon admission to work, study

2. periodic – identification of early signs of occupational diseases at work

3. targeted – identification of specific diseases

2. Infectious

Quarantine – plague, cholera, smallpox, etc.

The most important non-epidemic ones are syphilis, tuberculosis, fungal diseases

Non-epidemic – influenza, ARVI

Epidemic – typhoid fever, salmonellosis, dysentery

Information about all infectious diseases must be reported to the CSES. Each group of this type of morbidity has its own documentation and a set of measures to combat them.

4. Hospitalized - characteristics of serious pathology, registration card of those leaving the hospital, indicators: frequency of hospitalizations, average duration of treatment, seasonality of hospitalization

5. With temporary loss of ability to work – applies to the working population. Accounting is based on certificates of incapacity for work and outpatient coupons. Indicators: number of cases, number of days in UT, average duration one case.

6. Major diseases – cardiovascular diseases, malignant neoplasms, injuries, mental disorders.

Morbidity rates. There are:

1. Primary or actual morbidity;

2. Widespread or painful;

3. Frequency of diseases identified during medical examinations or pathological involvement.

Definitions of primary incidence and prevalence:

Primary incidence- this is the number of diseases diagnosed for the first time in life within 1 year. All acute diseases and chronic diseases diagnosed for the first time in life are taken into account upon first visit to the medical institution(relapses chronic pathology arising during the year are not taken into account).

Morbidity or prevalence of diseases- this is the totality of all acute and all chronic diseases registered in a given calendar year. Morbidity is always higher than the level of morbidity itself. The morbidity indicator, in contrast to morbidity, indicates dynamic processes occurring in the health of the population and is more preferable for identifying causal connections. The morbidity indicator gives an idea of ​​both new cases of the disease and previously diagnosed cases, but with an exacerbation of which the population came in a given calendar year.

Pathological affection- the totality of all diseases and pathological conditions identified during comprehensive medical examinations. This indicator gives an idea of ​​the number of patients registered on a certain date. The main focus is on chronic pathology and in most cases of this disease with which the population did not go to medical institutions.

Methods for studying morbidity. Methodology for calculating indicators, their levels in Russia.

1. Solid;

2. Selective

Solid - acceptable for operational purposes. Selective - used to identify relationships between incidence and factors environment. The sampling method was used during census years.

Identification of patterns, morbidity, and connections is possible only with the selective method by copying passport and medical data from primary accounting documents onto a statistical card.

When assessing the level, structure and dynamics of morbidity among the population and its individual groups, it is recommended to compare with indicators for Russian Federation, city, district, region. Unit of observation when studying general morbidity is the patient’s primary visit in the current calendar year regarding the disease. Basic accounting documents to study general morbidity, this is: a medical card and a statistical certificate for a specified diagnosis. The overall incidence is calculated per 1000, 10,000 population. In the structure of general morbidity in Russia, the first place is occupied by diseases of the respiratory system, diseases of the nervous system and sensory organs are in second place, and diseases of the circulatory system are in third place. Among children (0 -14) years old, infectious diseases occupy second place in the structure of overall morbidity, the share of which is 9.7%.

The incidence of infectious diseases is studied by recording each case of an infectious disease or suspicion of an infectious disease, for which an accounting document is issued - an emergency notification of an infectious disease. An emergency notification is sent within 12 hours to the center of state sanitary and epidemiological supervision and registered in a log infectious diseases. Based on the entries in this journal, a report is compiled on the movement of infectious diseases for each month, quarter, half-year, and year. Unit of observation when studying infectious diseases is a case of infectious disease. Calculated for 10,000, 100,000 people. The study of infectious morbidity includes identifying the source of infection, analyzing seasonality, and analyzing the effectiveness of anti-epidemic measures. In the Russian Federation, the highest morbidity rate is in the ARVI group, which accounts for 87% of the total infectious morbidity rate. The incidence of influenza per 100,000 population is 3,721. acute infection upper respiratory tract 20.V last years Vaccination recommended by WHO is used for mass prevention.

The most important non-epidemic diseases: tuberculosis, sexually transmitted diseases, mental illness, mycoses, malignant neoplasms, cardiac vascular diseases. An accounting document is a notification about the most important non-epidemic diseases. The unit of observation for these diseases is the sick person. Morbidity records are kept in dispensaries. The incidence of tuberculosis in Russia increased by 25%, among children by 18%. The highest incidence rate is observed in Komi, Dagestan, Volgograd region, Moscow. This situation is associated with large emigration of the population, with a decrease in the quality of nutrition, with a decrease in the number of patients open form tuberculosis.

Morbidity with temporary disability.
The unit of observation is each case of temporary disability.
An accounting document - a certificate of incapacity for work (has not only medical and statistical, but also legal financial significance). Recalculation per 100 employees.

Basic indicators:

1. Morbidity structure in the case.

2. Morbidity structure in calendar days.

3. Number of cases per 100 workers.

4. Number calendar days per 100 workers.

5. Average duration one case of disease.

Average level in Russia:

80-120 cases per 100 workers

800-1200 calendar days per 100 workers.

The incidence rate is currently decreasing. Reporting document - Form 16 VN. IN Lately for the in-depth methodology, the in-depth analysis method is used (not for everyone, but for those who have worked in the institution for at least 1 year). All 5 indicators are studied, but taking into account length of service, gender, and professional experience, and risk groups are determined.

In an in-depth study of risk groups:

1. Frequently ill: 4 times or more etiologically related diseases and 6 times or more etiologically unrelated diseases.

2. Long-term ill patients: in a calendar year, 40 days or more of etiologically related diseases and 60 days or more of etiologically unrelated diseases.

3. Frequently sick for a long time: 4 times or more in a calendar year and 40 days or more with etiologically related diseases, 6 times or more and 60 days or more with etiologically unrelated diseases.

With an in-depth study, a health index is calculated - this is the percentage of people who have never been sick this year (normally 50-60%).

Ministry of Health of the Russian Federation

State budget educational institution higher professional education

"Northwestern State medical University named after I.I. Mechnikov"

Ministry of Health of the Russian Federation

Department of Public Health and Healthcare

ANALYSIS OF INCIDENCE IN THE POPULATION

edited by z.d.n. RF, prof. V.S. Luchkevich

Educational and methodological manual

Saint Petersburg

UDC 312.6001.8 BBK 51.18

Analysis of population morbidity: educational and methodological manual / ed. V.S. Luchkevich. – SPb.: North-Western State Medical University named after. I.I. Mechnikova, 2015. – 47 p.

Team of authors: V.S. Luchkevich, P.N. Morozko, G.M. Pivovarova, N.I. Pustotin, V.P. Panov, I.L. Samodova, A.Yu. Lomtev, E.V. Mironchenko, E.A. Abumuslimova, G.N. Marinicheva, T.V. Samsonova, A.Sh. Kalichava.

Reviewer: head. Department of Social Hygiene, Management and Health Economics, North-Western State Medical University named after. I.I. Mechnikova, Doctor of Medical Sciences, Professor Vladimir Nikolaevich Filatov

The educational and methodological manual is devoted to the methodological aspects of the study, calculation and analysis of indicators of various types of morbidity, necessary for a comprehensive assessment of the health of individual groups and contingents of the population of an administrative territory, to determine the effectiveness of treatment and preventive, hygienic and anti-epidemic measures.

The educational and methodological manual contains the basics of population morbidity as the most important indicator of public health, a criterion for assessing the quality and effectiveness of health work, an objective and sensitive indicator of medical and social well-being. The educational manual reflects the causes and risk factors of morbidity, and determines the consequences of the disease’s influence on health.

The educational and methodological manual is intended for students in the field of training (specialty) 060101 “General Medicine” and 060105 “Medical and Preventive Care”.

Approved as an educational and methodological aid

TOPIC: Analysis of population morbidity.

STUDENT CONTENT– students in the field of training (specialty) 060101 “General Medicine” and 060105 “Preventive Medicine”.

DURATION OF PRACTICAL LESSON – 4 hours (in

academic hours)

OBJECTIVE OF THE LESSON: to study the basics of medical, social and clinical-statistical analysis of morbidity in various population groups and learn to use health data to assess the effectiveness of treatment and health measures, as well as to justify organizational forms of preventive measures.

As a result of studying the topic, the student should know:

1. The concept of public health. Health criteria. Comprehensive assessment of population health.

2. Definition of the concept of morbidity, pain, pathological involvement.

3. Types of morbidity. Methods and sources for studying morbidity.

4. Morbidity according to negotiability data.

5. Morbidity according to medical examinations.

6. Morbidity studied based on cause of death registration data.

7. Status, trends and forecast of changes in health indicators of various population groups, taking into account the influence socio-economic conditions.

8. Morbidity according to studies of the causes of disability.

9. Basic concepts of the International Statistical Classification of Diseases (ICD).

As a result of studying the topic, the student should be able to:

1. Know how to register correctly individual species morbidity with the definition of observation units for each type of morbidity.

2. Be able to analyze data from summary statistical forms (reports), assess the level and structure of registered morbidity.

3. Be able to assess morbidity based on hospitalization data for inpatients.

4. Be able to analyze data on newly diagnosed pathology and accumulated chronic forms diseases based on the results of comprehensive medical examinations.

5. Be able to calculate and analyze morbidity indicators (structure, level, dynamics), with the construction graphic images, identifying relationships between morbidity and risk factors.

HEALTH

A-priory World Organization health (WHO): “Healthy

Vieux is a state of complete physical, spiritual and social well-being, and not just the absence of disease and physical defects.”

IN According to Federal law dated November 21, 2011 N 323-FZ) Health

level is a state of physical, mental and social well-being of a person in which there are no diseases, as well as disorders of the functions of organs and systems of the body.”

IN medical and social research in health assessment is advisable

distinguish four levels:

1. Health individual person– individual health.

2. Health of social and ethnic groups – group health.

3. The health of the population of administrative territories is regional health

4. Population health – public health.

1. Deduction of gross national product for health care.

2. Availability of primary medical and social assistance.

3. Population coverage medical care.

4. Population immunization level.

5. The extent to which pregnant women are examined by qualified specialists.

6. Children's nutritional status.

7. Infant mortality rate.

8. Average life expectancy.

9. Hygienic literacy of the population.

Based on WHO materials, the Russian Ministry of Health offers the following definitions of health.

Public Health – a medical and social resource and potential of society that contributes to ensuring national security.

Population health – a medical, demographic and social category that reflects the physical, mental, social well-being of people carrying out their life activities within certain social communities.

A more complete definition of public health was developed at a seminar of heads of organizational departments:

Public Health – this is the most important economic and social potential of the country, due to the impact various factors environment and lifestyle of the population, allowing to ensure an optimal level of quality and safety of people's lives.

Health is a state that ensures an optimal relationship between the body and the environment and promotes the activation of all types of human life (labor, economic, household, recreational, family planning, medical and social, etc.).

Health criteria.

The main criteria characterizing public health are:

1. Medical and demographic(fertility, mortality, natural increase, infant mortality, frequency of premature births, expected life expectancy.

2. Morbidity (general, infectious, with temporary disability, major non-epidemic diseases, hospitalized, according to medical examinations).

3. Primary disability.

4. Indicators of physical development.

5. Mental health indicators.

All criteria are evaluated dynamically.

Comprehensive assessment of population health.

At comprehensive assessment the health status of adults, the distribution into health groups is as follows.

The first group consists of healthy individuals (who have not been sick for a year or who rarely see a doctor without losing their ability to work).

The second group consists of practically healthy individuals, with functional and some morphological changes, or who were rarely ill during the year (isolated cases of acute diseases).

The third group is patients with long-term chronic diseases (more than four cases and 40 days of disability per year).

The fourth group is patients with long-term chronic diseases (compensated state).

The fifth group is patients with frequent exacerbations of long-term diseases.

However, the division of both adults and children into health groups is quite arbitrary.

To assess individual health, a number of very conditional indicators are used: health resources, health potential and health balance.

BASIC CONCEPTS OF MORTIDITY

Definition of the concept of morbidity, primary morbidity, pain, pathological involvement.

The morbidity rate of the population is the most important indicator public health, a criterion for assessing the quality and effectiveness of health work, the most objective and sensitive indicator of medical and social well-being. Reducing the level of morbidity among the population is of great social and economic importance, constitutes one of the key social and hygienic problems and requires the active participation of legislative and executive power in the preparation and implementation special programs for health promotion and social protection population. Studying the causes and risk factors of morbidity, determining the consequences of diseases on health, and developing ways to prevent diseases are the priority professional tasks of workers in medical institutions. Thus, morbidity data is a tool for operational guidance and health management. Moreover, incidence rates reflect real picture life of the population and make it possible to identify problematic situations for the development of specific measures to protect public health and improve it on a national scale.

According to WHO definition, a disease is any subjective or objective deviation from the normal physiological state of the body.

Thus, the concept of “disease” is broader than the concept of “disease”.

An important direction in the study of morbidity is the assessment of the influence of risk factors of conditions and lifestyle, analysis of the relationships between medical, social, hygienic, genetic, organizational, clinical and other factors that contribute to the formation of the most common forms of diseases. The use of modern statistical techniques has made it possible to establish that a higher level of morbidity in the population depends not only on adverse effects environmental factors, but also from a number of biological, socio-economic, social conditions and lifestyle.

One of the principles of modern healthcare is the preservation of the health of the healthy, which makes it possible to give priority to the state and social activities in the field of disease prevention. The disease is mainly available for registration when the patient seeks medical help. Morbidity is one of the criteria for assessing the health status of the population and shows the level and frequency of spread of all diseases

taken together and each individually among the population as a whole and its individual age, gender, social, professional and other groups.

Morbidity is an indicator that characterizes the level, prevalence, structure and dynamics of registered diseases among the population as a whole or in its individual groups and serves as one of the criteria for assessing the work of a doctor, medical institution, or health authority in the territory.

Morbidity statistics include the following indicators:

1. Morbidity itself (primary morbidity).

2. Prevalence (morbidity).

3. Pathological damage.

4. True morbidity.

Primary morbidity (morbidity itself) is the total

the number of newly emerging diseases that were not taken into account anywhere in previous years and were detected among the population for the first time in a given calendar year (relapses of chronic pathology that occur during the year are not taken into account). It is calculated as the ratio of the number of newly emerging diseases to the average population, multiplied by 1000, expressed in ppm.

Registered using statistical coupons (account f. 025-2/u) of specified diagnoses with a sign (+).

Cases of acute diseases are recorded whenever they occur, cases of chronic diseases are recorded only once a year.

Morbidity (prevalence of diseases) - this is the totality of all diseases existing among the population, both those first identified in this calendar year, and those registered in previous years, but for which the patient returned again in a given year (registered according to all statistical coupons of updated diagnoses, account f. 025-2/у), expressed in ppm. Statistically expressed as the ratio of the number of all diseases in the population per year to the average population, multiplied by 1000.

Between the concepts of morbidity and morbidity there is significant difference. Soreness is always higher than the level primary disease

bridges.

Indicator of actual morbidity in contrast to the pain of the swollen

Describes the dynamic processes occurring in the health of the population and is more preferable for identifying causal relationships.

Pain index gives an idea of ​​both new cases of diseases and previously diagnosed cases, but with an exacerbation of which the population came forward in a given calendar year. The pain index is more stable in relation to various influences environment, and its increase does not always mean the presence of negative changes in the health status of the population. This increase may occur as a result of advances in medical science and practice in the diagnosis, treatment of patients and prolongation of their lives, which leads to the “accumulation” of contingents registered at dispensaries.

Primary incidence is an indicator that is more sensitive to changes in environmental conditions in the year under study; by analyzing this indicator over a number of years, one can obtain the most correct idea of ​​the frequency of occurrence and dynamics of morbidity, as well as the effectiveness of a complex of social, hygienic and therapeutic measures aimed at reducing it.

In the specialized literature the term “ accumulated morbidity” – this is the totality of all cases primary diseases, registered over a number of years when seeking medical help.

The cumulative incidence rate per 1000 population of the corresponding age is calculated. This morbidity indicator most reliably reflects the health of the population studied by the appeal method.

Pathological affection – a set of diseases and pathological conditions identified by doctors through active medical examinations of the population. Statistically expressed as the ratio of the number of disease cases present in a country this moment, to the average population, multiplied by 1000, expressed in ppm.

These are mainly chronic diseases, but currently existing acute diseases can also be taken into account.

Periodic and mass medical examinations make it possible to identify previously unknown chronic diseases for which the population does not actively seek help. medical institutions. Cases of initial (hidden) manifestations of certain diseases must be taken into account. The advantage of the method of active medical examinations is also the clarification of the diagnosis of certain chronic diseases and pathological abnormalities.

Reliable information about the size and nature of morbidity in various groups population (age, sex, social, professional, etc.) are necessary to assess trends in the health of the population, the effectiveness of medical and social measures, planning various types specialized assistance, rational use of material and human resources in healthcare.

True incidence - This is the appeal rate plus morbidity according to medical examinations and minus unconfirmed diagnoses during medical examinations.

When analyzing morbidity, a number of indicators of the incidence of diseases are calculated for individual age and sex groups.

Depending on the purpose of the study, various statistical materials and accounting documents are used ( medical records, emergency notices, certificates of incapacity for work, cards of those leaving the hospital, medical death certificates, other special forms and questionnaires). When choosing the main diagnosis, you should be guided by “ International classification diseases and health problems” (10th revision, 1993, WHO). When diagnosing and coding morbidity, preference should be given to: 1) the underlying disease rather than the complication; 2) heavier and fatal disease; 3) infectious, not non-communicable diseases; 4) acute form of the disease, not chronic; 5) specific disease associated with certain working and living conditions.

TYPES OF MORDABILITY.

METHODS AND SOURCES FOR STUDYING INCIDENCE

Classification of types of morbidity.

1. According to circulation data:

a) general morbidity; b) infectious morbidity;

c) hospital morbidity; d) morbidity with temporary disability;

e) the most important non-epidemic diseases (tuberculosis, syphilis, sexually transmitted diseases, etc.).

2. According to medical examinations and dispensary observation: children,

conscripts, working teenagers and other decreed categories of the population.

3. According to the causes of death.

4. According to a study of the causes of disability.

Of these, two types are subject to general continuous current accounting, including data on causes of death and data from preventive medical examinations, and three types are subject to additional special registration and statistical accounting, due to their special medical and social significance and signal-operational significance for the organization of preventive measures.

Can be studied separately detection rate – number of cases of concern

levany per 1000 examined according to preventive examinations and dispensary observation, as well as data on causes of death. Sources of information and types of morbidity are presented in Diagram 1.

Each type of morbidity has an accounting and reporting form. The study of only one of the listed species is only part of the information on overall morbidity. When studying morbidity, especially during short term, for example, a year, according to the negotiability data, it is not always possible to take into account all cases of the disease. This especially applies to the initial forms of the disease.

WHO points out that whatever incidence rate is calculated, it must meet a number of requirements: be reliable, objective, sensitive and accurate.

Each of the methods for studying morbidity has its own characteristics regarding the quality and significance of the data collected on their basis.

Reasons for separately studying each type of morbidity:

1. Infectious morbidity requires rapid implementation of anti-epidemic measures.

2. Hospital morbidity - information about it is used to plan bed capacity.

3. Morbidity with temporary disability determines economic costs.

4. The most important non-epidemic morbidity - provides information on the prevalence socially determined diseases.

Morbidity has vital importance in studying the health status of the population. Morbidity is studied based on the analysis of medical documentation of outpatient and inpatient medical institutions: cards of patients who left the hospital; statistical coupons for registering updated diagnoses; emergency notifications of infectious diseases; death certificates, etc.

The study of morbidity includes quantitative ( incidence rate), quality ( morbidity structure) and individual ( frequency of diseases suffered per year) assessment.

There are:

morbidity itself- newly registered diseases in the reporting year;

prevalence of the disease (morbidity)- diseases that re-emerged in a given year and have transferred from the previous year to the present moment.

Pathological affection- a set of diseases and pathological conditions identified by doctors through active medical examinations of the population; statistically expressed as the ratio of the number of diseases currently present to the average population multiplied by 1000.

Workers are divided into health groups as follows:

healthy (who did not have a single case of disability in the year);

practically healthy (those who had 1-2 cases of disability per year due to acute forms of disease);

who had 3 or more cases of disability in a year due to acute forms diseases;

having chronic diseases, but no cases of disability;

with chronic diseases and cases of loss of ability to work due to these diseases.

The morbidity rate of the population shows the level, frequency, prevalence of all diseases, taken together and each separately, among the population as a whole and in separate groups by age, gender, profession.

Morbidity rates are determined by the corresponding figure: per 1000, 10,000 or 100,000 people.

Epidemiological data strongly suggests that The incidence is higher in men than in women.

Men die from myocardial infarction 7.5 times more often at the age of 40 to 49 years; 5.5 times - at the age of 50 to 55 years and 2.5 times - at the age of over 60 years. The unequal life expectancy of men and women is also explained by genetic differences in the chromosomal apparatus of the cell nucleus, the presence of a double set of X chromosomes in women, which determines the higher reliability of important mechanisms of biological regulation of the cell.

Disability indicators

Disability- health impairment with a persistent disorder of body functions caused by diseases, birth defects, consequences of injuries leading to limitation of activity.

Disability and disability of the population are the most important indicators of public health and have not only medical, but also socio-economic significance.

According to WHO, every fifth person in the world

(19.3%) becomes disabled due to malnutrition,

about 15% became disabled due to bad habits(alcoholism, drug addiction, drug abuse),

15.1% received disability due to injuries at home, in production and on the road.

On average, people with disabilities make up about 10% of the world's population.

In Russia average level disability rates range from 40 to 49 per 10,000 inhabitants.

The causes of primary disability are mainly 4 groups of diseases:

Diseases of the circulatory system - 27 - 35% of cases;

Malignant neoplasms - 23 - 29%,

Injuries - about 10%,

Diseases of the nervous system and sensory organs - 5-7%.

Most people (80 - 90%) become disabled at working age. At the same time, the level of rehabilitation and restoration of working capacity is insignificant (10-12%).