Lecture 2 -health Info

HEALTH INFORMATION: Definition, Uses And Resources. By Dr. Aesha Farheen Department of Community & Family Medicine, Medical College(Girls center) King Khaled University, Abha

HEALTH INFORMATION SYSTEM • DEFINITION: A Mechanism for the collection, processing,analysis and transmission required for organising and operating health services , and also for research and training.

REQUIREMENTS • The system should be population based and Problem oriented • The system should avoid the unnecessary agglomeration of data. • The system should employ functional and operations terms (eg. episodes of illness,treatment regimens,laboratory tests.)

…Requirements Contd • The system should express information briefly and imaginatively (Tables, charts, percentages). • The system should make provision for the feedback of data.

COMPONENTS OF A HEALTH INFO SYSTEM • Demographic and vital events. • Environmental health statistics • Health Status-Mortality, morbidity, disability and quality of life. • Health Resources-facilities, beds, man-power • Utilisation and non-utilisation of health servicesattendance, admissions, waiting lists. • Indices of outcome of medical care. • Financial statistics (cost, expenditure) related to a particular objective.

USES OF HEALTH INFO SYSTEM • To measure the health status of the people and to qualify their health problems and medical and health care needs. • For comparison of health status–local national and international. For comparison data should be subjected to standardisation and quality control. • Planning administration and effective management of health services and programmes.

..…USES Contd • For assessing whether health services are accomplishing their objectives in terms of their effectiveness and efficacy. • For assessing the attitudes and degree of satisfaction of the beneficiaries with the health system. • For research into particular problems of health and disease.

SOURCES OF HEALTH INFORMATION 1. CENSUS 2. REGISTRATION OF VITAL EVENTS 3. NOTIFICATION OF DISEASES 4. HOSPITAL RECORDS 5. DISEASE REGISTERS 6. EPIDEMIOLOGICAL SURVEILLANCE 7. OTHER HEALTH SERVICE RECORDS 8. ENVIRONMENTAL HEALTH DATA 9. HEALTH MANPOWER STATISTICS 10. POPULATION SURVEYS.

.1CENSUS • The word 'census' origins in fact from ancient Rome, coming from the Latin word 'censere', meaning ‘estimate’. A census is the process of obtaining information about every member of a population. The term is mostly used in connection with national 'population and housing censuses' (to be taken every 10 years according to United Nations recommendations); agriculture censuses (all agriculture units) and business censuses (all enterprises).

Census:Historical perspective • The first known census was taken by the Babylonians in 3800 BC, nearly 6000 years ago. Records suggest that it was taken every six or seven years and counted the number of people and livestock, as well as quantities of butter, honey, milk, wool and vegetables.

• The Bible relates stories of several censuses.

• One of the earliest documented censuses was taken in 500-499 BC by the Persian Empire's military for issuing land grants, and taxation purposes. • Censuses were conducted in the Mauryan Empire in ancient India. • Rome conducted censuses to determine taxes. • The world's oldest extant census data comes from China during the Han Dynasty . Taken in the fall of 2 AD, it is considered by scholars to be quite accurate.

Census and the KSA • Population censuses have been taken in Saudi Arabia in 1962/63 (incomplete), 1974 (complete but not reliable), 1992 and 2004. • An agriculture census was taken in 1999.

Census VS Sampling • The census can be contrasted with sampling in which information is only obtained from a subset of a population. • Census data is also commonly used for research, business marketing, planning purposes and not at least as a base for sampling surveys.

CENSUS COSTS • It is widely recognized that population and housing censuses are vital for the planning of any society. Traditional censuses are however becoming more and more costly. A rule of thumb for census costs in developing countries have for a long time been 1 USD / enumerated person. More realistic figures today are around 3 USD.

.2REGISTRATION OF VITAL EVENTS • Legal registration,statistical recording,and reporting of the occurrence of and the collection, compilation,presentation, analysis and distribution of statistics pertaining to vital events. (UN Definition)

VITAL EVENTS • Vital events in demographic literature are defined as events which bring changes in composition of human population. • Live births • Deaths • Foetal deaths • Marriage • Divorce Adoption • Legitimations • Recognitions • Annulmants • Legal separations

• Previously only births and deaths were treated as Vital Events. With the passage of time and development of the subject;Marriages,Widowhood and Divorces came under the domain of Vital Events. • These events do not cause increase/decrease in number of people directly but have an indirect impact of change in population size.

HOSPITAL RECORDS.3 • RECORDS OF PATIENTS ARE MAINTAINED IN THE HOSPITALS REGARDING ALL THEIR ASPECTS. • THEY ARE A SOURCE FOR DATA IN MANY TYPES OF STUDIES,ESP SOME RETROSPECTIVE STUDIES AND THE CASE CONTROL STUDIES ETC.

DISEASE NOTIFICATION.4 • Some disease are notifiable i.e to be reported at once to the health authorities at higher levels of administration. • At the national level, it helps to plan and implement health promotional and intervention strategies. • It helps to monitor disease trends over time. In time this will permit an evaluation of the effectiveness of promotional and intervention strategies. • It helps to implement immediate interventions .

DISEASE REGISTERS.5 In epidemiology the term register is applied to the file of data concerning all cases of a particular disease or other health-relevant condition in a defined population such that the cases can be related to a population base. Last, 1995

AIM OF DISEASE REGISTERS • To strengthen the information base on chronic diseases in the population by establishing a series of registers specific for disease is called as disease registers.

HOW DRS WORK Primary care trusts identify and maintain registers of those at greatest risk from serious illness - concentrating particularly on areas where ill health is most prevalent – so that people can be offered preventive treatment”

USES OF DISEASE REGISTERS • Patient care – regular review and recall – structured care programmes – monitoring high risk groups – managing demand / regulating access – communication – risk stratification

…Uses Contd • Public Health – surveillance – planning the provision of health care – monitoring the burden of ill health – monitoring the impact of prevention

…Uses Contd • Technology assessment • Research – descriptive studies – improving the performance of clinical trials – studies of process – hypothesis testing when trials are not available

EPIDEMIOLOGICAL.6 SURVEILLANCE • Is the systematic collection, analysis and dissemination of health data for the planning, implementation and evaluation of public health programmes. Epidemiological surveillance is now universally recognized as an essential component of public health .

• Established surveillance systems should be regularly reviewed on the basis of explicit criteria of usefulness, cost and quality; systems should be modified as a result of such review. • Attributes of quality include: (i) sensitivity, (ii) specificity, (iii) representativeness, (iv) timeliness, (v) simplicity, (vi) flexibility and (vii) acceptability.

ENVIRONMENTAL HEALTH.7 DATA • Environmental health addresses all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviours. It encompasses the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments.

• Proper environmental management is the key to avoiding the quarter of all preventable illnesses which are directly caused by environmental factors. The environment influences our health in many ways — through exposures to physical, chemical and biological risk factors, and through related changes in our behaviour in response to those factors. • Thirteen million deaths annually are due to preventable environmental causes. Preventing environmental risk could save as many as four million lives a year, in children alone, mostly in developing countries.

:Env health data is about • Air quality, including both ambient outdoor air and indoor air quality, which also comprises concerns about environmental tobacco smoke. • Body art safety, including tattooing, body piercing and permanent cosmetics. • Climate change and its effects on health. • Disaster preparedness and response.

• Food safety, including in agriculture, transportation, food processing, wholesale and retail distribution and sale. • Hazardous materials management, including hazardous waste management, contaminated site remediation, the prevention of leaks from underground storage tanks and the prevention of hazardous materials releases to the environment and responses to emergency situations resulting from such releases.

• Childhood lead poisoning prevention. • Land use planning, including smart growth . • Liquid waste disposal, including city wastewater treatment plants and on-site waste water disposal systems, such as septic tank systems and chemical toilets. • Medical waste management and disposal. • Noise pollution control.

• Housing, including substandard housing abatement and the inspection of jails and prisons. • Occupational health and industrial hygiene . • Radiological health, including exposure to ionizing radiation from X-rays or radioactive isotopes. • Recreational water illness prevention, including from swimming pools, spas and ocean and freshwater bathing places.

• Safe drinking water. • Solid waste management, including landfills, recycling facilities, composting and solid waste transfer stations. • Toxic chemical exposure whether in consumer products, housing, workplaces, air, water or soil. • Vector control, including the control of mosquitoes, rodents, flies, cockroaches and other animals that may transmit pathogens.

EXAMPLES OF ENV HEALTH DATA • • • • • • • •

Air pollution levels Safe water availability Sanitation Drinking water quality Radiation levels Soil pollution levels Waste management Water related diseases

HEALTH MANPOWER.8 STATISTICS • The availability of health personnel. It includes the demand and recruitment of both professional and allied health personnel, their present and future supply and distribution, and their assignment and utilization.

HEALTH MANPOWER STATISTICSKSA • Indicator Number • Physicians (number) ? 34,261 (2004) • Physicians (density per 1 000 population) ? 1.37 (2004) • Nurses (number) ? 74,114 (2004) • Nurses (density per 1 000 population) ? 2.97 (2004) • Dentists (number) ? 4,235 (2004)

..Data contd • Dentists (density per 1 000 population) ? 0.17 (2004) • Pharmacists (number) ? 5,485 (2004) • Pharmacists (density per 1 000 population) ? 0.22 (2004) • Other health workers (number) ? 39,073 (2004) • Other health workers (density per 1 000 population) ? 1.57 (2004)

POPULATION SURVEYS.9 • CPS(Current population surveys) • Sample surveys • Census

OTHER HEALTH SERVICES.10 RECORDS Client Records Laboratory Inspection Records Laboratory Test Requests Licensure Records Non-Student Medical Records Patient Logs Patient Satisfaction Surveys Pharmacy Prescription Dispensation Records Practitioner Schedules Radiographic Quality Assurance Records Health Insurance Records Surgical Instrument Sterilization Records

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