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Social Medicine and Health Care Organization as a science

Social Medicine and Health Care Organization as a science. Friedrich Engels (1820-1895) Called attention to the health of the working class. Rudolf Ludwig Karl Virchow (1821-1902) the “Father” of Social Medicine. Those measures can be divided into 2 groups:. -measures against the diseases;

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Social Medicine and Health Care Organization as a science

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  1. Social Medicine and Health Care Organization as a science

  2. Friedrich Engels (1820-1895)Called attention to the health of the working class

  3. Rudolf Ludwig Karl Virchow (1821-1902)the “Father” of Social Medicine

  4. Those measures can be divided into 2 groups: • -measures against the diseases; • -measures aimed at improving health.

  5. “The physician is the natural attorney (advocate) for the poor.”

  6. Before the beginning of the 20th century 3 ways of health protection were formed: • with help of state measures(the promulgation of different medical and social work); • with help of social measures; • with help of medical insurance.

  7. Medicine is a social science, and politics nothing but medicine on a grand scale. - R. Virchow, Die Medicinische Reform, 1848

  8. “Social hygiene” studies interaction of social factors and human health including changing of need in medical aid with the purpose of making the rational economic system of civic health protection measures (K.Gargov, 1969).

  9. Social medicine and organization of health protection is a science about social conformity with human health and the ways of its improvement by rational organization of health protection.

  10. Worsening inequality in the US Source: Left Business Observer

  11. Old Conceptual Model Well- Being Human Rights Health

  12. The World Assembly of Health Protection (WAHP) in its resolution number 23.61 considers that the optimum development of health protection in any country needs making use of generalized experience of health protection development in all the countries of the world. The most effective principles marked by experience of different countries of building and development of national health protection system are the following:

  13. New Conceptual ModelFramework for Understanding Human Rights Health Human Rights Health Human Rights Health

  14. Proclamation of the responsibility of state and society for health protection of the population, which is to be incarnate on the basis of carrying out the complex of economic and social measures which promote directly or collaterally to reach the highest health level of population by creating general national system of health protection services on the basis of the only national plan and local plans, and also by goal-directed and effective use of all resources, which society may apport on every stage of its development for requirements of health protection;

  15. The Evolution of Epidemics Virulence of the Causative Agent (M tuberculosis) Population Susceptibility Course of Epidemic

  16. Reported TB Cases US, 1953-2002 100,000 70,000 * 50,000 Cases Log Scale * 30,000 20,000 10,000 53 60 70 80 90 00 Year *Change in case definition

  17. Reported TB Cases US, 1983-2002 No. of Cases * 1981 1985 1989 1993 1997 2002 Year * provisional

  18. The basic principles of the Public Health service: • The determination of the Public Health service with the priority direction of the sasaity activities and government as the one of the basic factors of the surviving and Ukrainian nation development. • The observance of the right and liberties of human and citizen according to the Public Health service and securing with the state guarantees. • The human direction, securing with priority, common to all mankind treasures in classical, national, grope or individual interests, medical-social protection of the most vulnerable part of the population.

  19. Excess TB cases 1985-92 • Infrastructure • deteriorated • Epidemic HIV • Immigration • Institutional • transmission • MDR TB JAMA 1994; 272:536

  20. Of the citizens, democratism and opened to general use of the medical aid and other services in the Public Health service. • Accordance to the task and social-economical level and cultural development of the sasaity, scientific explanation, material and technical and financial securing. • Orientation to the modern health standards and medical aid. • The unit of the old traditions and achievements in Public Health service.

  21. TB Morbidity US, 1997-2002 Year Cases Rate* 1997 19,851 7.4 1998 18,361 6.8 1999 17,531 6.4 2000 16,377 5.8 2001 15,989 5.6 2002** 15,087 5.2 *Cases per 100,000 **Provisional

  22. Social medicine – isa science that studies social laws of peoples health and characterizes the ways of its improvement according to rational organization of public health services.

  23. TB Case Rates, US, 2002 D.C. < 3.5 (year 2000 target) 3.6 - 5.2 > 5.2 (national average) Rate: provisional cases per 100,000

  24. Health is a condition of complete social, mental andbiological well-being, and not just the absence of diseases or physical defects

  25. Reported TB Cases by Race/Ethnicity, US, 2001 Hispanic (25%) White, non-Hispanic (21%) American Indian/ Alaska Native (1%) Asian/Pacific Islander (22%) Black, non-Hispanic (30%)

  26. 1. Historical, establishes historical regularities of development of public health and its protection; • 2. Sociological, that allows studying social structure of a society and its influence on health; • 3. Experimental, allows studying advantages (lacks) of organizational forms of medical service; • 4. Expertise, which help quality and efficiency of medical service is studied; • 5. Economical, that enable to determine economic efficiency of systems of medical service.

  27. Number of TB Cases inUS-born vs. Foreign-born Persons, US, 1992-2002* No. of Cases *2002 count is provisional

  28. Statistical totality isthe common number of units of supervision, taken in the set borders of space and time.

  29. Countries of Birth for Foreign-born Persons Reported with TB US, 2002* Other Countries (36%) Mexico (25%) Philippines (11%) S. Korea (3%) Vietnam (9%) Haiti (3%) India (8%) China (5%) *Provisional

  30. The ways of formation of the statistic integrity continuous By the volume of observation selective accidental volume mechanic selection typological serial regional observation combinative flowing By the time of observation one-moment direct By the type of observation copying of the data By anamnesis questionnaire interrogatory

  31. The stages of development of statistical material are following: • control /logical and technical/; • enciphering /code/ of registered signs by numbers, letters of alphabet; • lay-out of cards on groups for the subaccount or groupment; • report of material; • deduction of statistical criteria /indexes/, their graphic image.

  32. There are two levels of medical service organizations in our independent state: • a) Ukrainian Public Health Service; • b) private doctors.

  33. The fundamental task of modern system of health protection in Ukraine is saving and strengthening of population health, improvement of medicare qualities, and development of concrete medical and prophylactic measures, forms and methods of work of the specialized services.

  34. WHO (World Health Organization) determines health as the state of complete social, biological and psychological prosperity, when functions of all organs and systems are balanced with an environment, absence of diseases, sick states or physical defects.

  35. The most essential among indices: • demographic (birth-rate, death rate, average life duration); • physical development (functional and biological development, harmoniousness); • morbidity (general, hospitalized, infectious); disability (primary and constant); • state (immunity, resistance of the systems, activity of enzymes, etc.).

  36. Risk factors are divided into 4 large groups: • 1) way of live (smoking, wrong food. Abuse of alcohol, harmful work, stresses, hypodynamia, using of drugs, incomplete family or family with many children, hyperurbanization) - 51-52%; • 2) environment (air, water, meal, radiation level, electromagnetic fields) - 20-21%; • 3) biological factors (heredity, constitution, sex, age) - 19-20%; • 4) medical factors (inoculation against infections, medical inspections, quality of medical treatment) - 8-9%.

  37. Groups of health • 1 group - healthy (0-1 case of acute respiratory illness per year); • 2 group - practically healthy (persons with the factors of risk; no more than 2-3 cases of acute respirator illness per year); • 3 group - patients with the compensated state (persons with chronic illnesses without complications; 4 and more cases of acute respirator illnesses per year); • 4 group - patients with the subcompensated state (persons with complications of chronic illnesses during a year); • 5 group - patients with the decompensated state (chronic patients in stage of decompensation).

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