BEPH_lesson03.pdf

Lesson 3 Information systems in support public health Biostatistics, Epidemiology and Public Health Prof. Eugenia García Zaragozá, PhD Bachelor in Dentistry ACADEMIC YEAR 2023-2024 ÍNDICE TABLE OF CONTENTS CONTENIDOS 1. Public Health ✓ Definition. Characteristics, Functions, ✓ Community health,...

Lesson 3 Information systems in support public health Biostatistics, Epidemiology and Public Health Prof. Eugenia García Zaragozá, PhD Bachelor in Dentistry ACADEMIC YEAR 2023-2024 ÍNDICE TABLE OF CONTENTS CONTENIDOS 1. Public Health ✓ Definition. Characteristics, Functions, ✓ Community health, The asset model, 2. Health Information systems ✓ Definitions. Objectives. Integration. Characteristics. Functions. Health Indicators. Types 3. Epidemiological surveillance ✓ ✓ ✓ History Objectives Elements 2 1. Public Health Definitions Public health is the science and art of preventing disease, promoting health and well-being and prolonging life through the organized efforts of society 3 1. Public Health Characteristics 1. Multi-institutional 2. Multisectorial 3. Multiprofessional 4. Multidisciplinary 4 1. Public Health Functions 1. Surveillance and assessment of health status of the population Public Health and the Tobacco problem 1. Through surveys, tobacco is identified as a public health problem 2. Search for effective policies 2. Effective policies are identified to reduce its consumption 3. Health promotion 3. Implementation of preventive measures to promote smoke-free spaces 4. Disease prevention 4. Awareness campaigns in all sectors of society. 5. Development of effective health programs and services that protect health 6. Evaluation of public health policies, strategies and services 5. Development of health programs to aid smoking cessation and implementation of health services for this purpose 6. Evaluation of the effect of the measures on the number of smokers 5 1. Public Health Community Cluster of people with at least one common characteristic (geographic location, occupation, ethnicity, housing condition, exposure to similar risk factor..) (WHO) Community health Community Health refers to the health status of a defined group of people and the actions and conditions, both private and public (governmental), to promote, protect, and preserve their health (McKenzie et al., 2005) Community diagnosis Quantitative and qualitative description of the health of citizens and the factors that influence their health including the population’s perception of their own health (WHO) 6 1. Public Health Community diagnosis. Process ▪ Initiation: (areas to be studied) ▪ Data collection: ▪ Primary data (questionnaires, observations..) ▪ Secondary data (review of record) ▪ Data analysis ▪ Diagnosis: (topics) ▪ Health status ▪ Determinants of health ▪ Potential for health interventions 7 1. Public Health The asset model of Public Health Selfesteem Positive solutions Capacity, hability and talent ASSET MODEL Health service Professional resource Problem DEFICIT MODEL Adapted from: Hernan N. Morgan A, Mena AL. Formación en salutogénesis y activos en salud. Escuela Andaluza de Salud. 2010 8 1. Public Health Health assets Any factor or resource that enhances the capacity of individuals, communities or populations to maintain health and wellbeing (Morgan & Ziglio, 2007) 9 10 1. Public Health Health assets: Salutogenesis How to generate health? Aaron Antonovsky (1923 – 1994) EEUU-Israel What causes some individuals to better cope with the daily stressors (and remain more healthy), while others fall ill in similar situations? 11 Health assets: Salutogenesis SENSE OF COHERENCE (soc): Had the ability to make Good use of “general resilience resources” money knowledge experience self-steem healthy habits commitment social support cultural capital intelligence traditions 12 1. Public Health Salutogenesis 13 1. Public Health Salutogenesis Community participation To discover the individual and collective capacities and talents, as well as the physical and organizational resources available 14 Community diagnosis and Health Information systems fundamentally build on the core of Epidemiological surveillance 15 2. Health Information systems (HIS) Definitions WHO 1973: Integrated system for the collection, storage, processing, analysis and transmission of the information related to the health of individuals necessary for the organization and operation of health services, as well as for research and teaching. MODERN CONCEPT: Goes beyond a statistical and administrative compilation to become a computer system made up of several specialized and coordinated subsystems Addressed to citizens, managers, health service providers and health policy makers 16 2. Health Information systems (HIS) KNOWLEDGE PROCESSING DECISION MAKING LEARNING DATA INFORMATION RESULTS 17 2. Health Information systems (HIS) Objectives 1. To convert data into intelligible information 2. To enable the correct use of information and make it available to users at the right time. Quality data: a. importance in promoting standards of patient care b. impact on government budgets 18 2. Health Information systems (HIS) Characteristics 1. Consistent 2. Relevant data 3. Integratable 4. Flexible 5. Simple and sustainable 6. Accesible 7. Local use of data 8. Sustained training 9. Staff implication 19 2. Health Information systems (HIS) Functions 1. Data collection 1. Primary data 2. Secondary data 2. Data validation 3. Storage of data 1. Individualized 2. Aggregated 4. Development of indicators 5. Presentation of the information 20 2. Health Information systems (HIS) Health indicators “A notion of public health surveillance that defines a measure of health (occurrence of a disease or other health-related event) or a health-related factor (health status or other risk factor) in a specific population” (WHO) Spanish National Health System Key Indicators: ✓ ✓ ✓ ✓ ✓ ✓ Health Level. Structural. Health system utilization Accesibility of the system Expenditure Quality of care http://inclasns.msssi.es/ 21 2. Health Information systems (HIS) Types 1. According to the base represented 1. Populational-based (Spanish National Health Interview Survey) 2. Individual-based (Hospital Episode Statistics) 2. According to the method of data collection 1. Registries 1. Disease (Cancer registries) 2. Patients (Electronic Medical Records) 2. Surveys 3. Notification systems (notifiable diseases / outbreaks and epidemics / microbiological information) 22 3. Epidemiologial Surveillance Definitions continuous, systematic, practical process of observation and evaluation 23 3. Epidemiologial Surveillance History and framework 24 3. Epidemiologial Surveillance History and framework 25 3. Epidemiologial Surveillance Objectives • Describe epidemiology of health problems of the population under study • To monitor trends in the rate of disease occurrence • Determine the risks of contagion • To formulate, implement and evaluate appropriate prevention measures. • Detect possible acute changes in the incidence of diseases. 26 3. Epidemiologial Surveillance Types PASSIVE ACTIVE SENTINEL WHO Health institutions themselves send routinely disease reports to the epidemiological surveillance officers Surveillance personnel actively seek information on the disease under investigation. Samples are taken directly from the source and sent for analysis Centers and professionals specialized in the disease under surveillance and high quality diagnostic laboratories. HOW Mere collection of the information that arrives through the different members of the surveillance network Medical personnel are contacted, health care facilities are visited, and health records are analyzed for signs of the disease. Competent authorities are also promptly informed through previously established channels medical records, weekly epidemiological bulletins, death certificates… surveys (morbidity, risk groups, socioeconomic), outbreak investigation, laboratory results (serology, cytology...) SOURCES They collect data as: -information about what is occurring in the reference population -indicative of a disease trend -to identify cases of a disease at an early stage. 27 3. Epidemiologial Surveillance When? ✓ Priority disease EPIDEMIC ✓ Frequency exceeds the usual ✓ There is a common source of infection ENDEMIC ✓ Cases are more severe than usual ✓ Unknown disease. OUTBREAK 28 3. Epidemiologial Surveillance In Spain: RENAVE network Red Nacional de Vigilancia Epidemiológica (National Network of Epidemiological Surveillance) BASIC SURVEILLANCE SYSTEM: 1. System of notifiable diseases 2. Notification of outbreaks and epidemics 3. Microbiological information system 29 3. Epidemiologial Surveillance System of notifiable diseases: I. Weekly numerical reporting sending of b.e.d. grouped in 4 weeks campylobacter, cryptosporidiosis, human spongiform encephalopathies, invasive H. influenza disease, invasive pneumococcal disease, giardiasis, hepatitis C, Chlamydia trachomatosis infection, salmonellosis urgent declaration with sending of b.e.d. cholera, diphtheria, yellow fever, Nile fever, viral hemorrhagic fevers, influenza, plague, poliomyelitis, rabies, SARS, smallpox, smallpox Weekly reporting with sending of b.e.d. botulism, brucellosis, anthrax, dengue fever, tick-borne encephalitis, meningococcal disease, Chikungunya disease, Mediterranean exanthematous fever, Q fever, typhoid fever, influenza, hepatitis A, hepatitis B, hydatidosis, gonococcal infection, E. Coli, legionellosis, leishmaniasis, leprosy, leprosy, leptospirosis, lymphogranuloma venereum, listeriosis, malaria, mumps, congenital rubella, measles, shigellosis, congenital syphilis, tetanus, neonatal tetanus, pertussis, congenital toxoplasmosis, trichinosis, tuberculosis, tularemia, varicella (chickenpox). Sending b.e.d. in an anual report Herpes zoster II. Special disease reporting HIV/AIDS II Regional endemic diseases Lyme disease 30 b.e.d: basic epidemiological data 3. Epidemiologial Surveillance Notification of outbreaks and epidemics ❑ When cases of a disease is aggregated in an area and time between the minimum and maximum of the incubation or latency period ❑ When a greater number of cases than expected occur in an area ❑ When a disease appears in an area that was free of it ❑ The occurrence of an acute collective intoxication due to a handling or consumption problem ❑ The occurrence of a natural catastrophe affecting the health of the community 31 3. Epidemiologial Surveillance Microbiological information system Selected Laboratories in each Autonomous Community to identify: ✓ Main etiological agents ✓ Detect epidemic outbreaks ✓ New emerging pathologies ✓ Monitor antibiotic resistance 32 Remember • Public health involves disease prevention, health promotion, community diagnosis, life prolonging and search, development and evaluation of health policies, strategies and services, with the participation of both governments and citizens (community). • Based on the assets model health policies should be directed to enhance the (salutogenic) skills and resources of disadvantaged people and neighborhood • HIS help to improve decision-making in health by monitoring health interventions with information (health indicators) being exchanged between public health agencies, clinicians/healthcare providers, individuals, and communities. • Community diagnosis and HIS build on the core of Epidemiological surveillance • Epidemiological surveillance means the systematic collection, analysis, dissemination and interpretation of health data necessary for planning, implementation and evaluation of public health policies. Research is carried out in an event of epidemic, endemic or outbreak 33 REFERENCIAS BIBLIOGRAPHY BIBLIOGRÁFICAS - Gordis L., Epidemiology, 4th Edition. 2009. Saunders Elsevier -Somerville M., Kumaran K., Anderson R. Public Health and Epidemiology at a Glance, First Edition. 2012. John Wiley & Sons, Ltd - Deter R., Gulliford M., Karim Q.A, Tam C.C. Global Public Health. Sixth Edition. Oxford University Press. 2015 34 Prof. Eugenia García Zaragozá, PhD [email protected] UCAM Universidad Católica de Murcia © © UCAM UCAM