Public Health

Question 1

What are aims of public health

Answer 1

Prevent disease
Promote health
Prolong life
Health surveillance

Question 2

What does public health look at

Answer 2

Population orientated

Physical, psychological and social well being

Question 3

What are wider social determinants

Answer 3

Education
Housing
Employment
Lifestyle

Question 4

What underpins

Answer 4

Epidemiology

Question 5

What is healthcare services

Answer 5

Ensuring quality of provision and access of healthcare

Question 6

What does it involve and how

Answer 6

Assess effectiveness, efficiency and acceptability

Epidemiological approach.

Question 7

What is health protection

Answer 7

Prevent transmission of infectious disease
Ensure safety of general environment
Deal with outbreaks

Question 8

What is health promotion

Answer 8

Enable people to increase control
Health education
Reduce social inequality
Wider NHS - local government / private sector

Question 9

3 aims of public health

Answer 9

Healthcare services
Health protection
Health promotion

Question 10

How is NHS made up / control

Answer 10

Government
14 territorial board - give data to ISD
Special boards
Public Health Scotland

Question 11

What are special boards

Answer 11

Drive national policies given to all health board
e.g. 
Health protection Scotland 
Healthcare improvement Scotland 
NES

Question 12

What is epidemiological healthcare needs assessment

Answer 12

Decide how to organise and run NHS to improve health of population

Question 13

What is inverse care law

Answer 13

Those in greater need are less likely to receive

Question 14

What is need, demand and supply

Answer 14

Need - ability to benefit
Demand - services people use
Supply - what is provided

Question 15

What is key elements

Answer 15

Incidence and prevalence
Effectiveness - RCT and other studies
Current service provision to know what needs to be changed

Question 16

What is health economics

Answer 16

Decide which healthcare services to provide based on financial services available

Question 17

What is economic efficiency

Answer 17

Maximisation from fixed resources

Question 18

What are QALY

Answer 18

Quality Adjusted Life Years

• How Rx improves quantity and quality of life
• Rate between 0-1

Question 19

What can you then do

Answer 19

Cost per QALY

Question 20

What are considered acceptable for money

Answer 20

If cost per QALY under 20-30 grand

Question 21

How else can you assess

Answer 21

Comparative - contrast services

Corporate - based on partnerships / collaboration and listening to views of patient and local people

Question 22

What is issue with healthcare needs assessment

Answer 22

Inadequate info on incidence / prevalence
Inadequate info on effectiveness
Complex patient pathway through NHS
No agreement on threshold for intervention
Political / medial pressure
Broader community issues impact on health

Question 23

How do we collect health information

Answer 23

Population census data
Birth and deaths (vital events)
Morbidity

Question 24

Why is it important to get

Answer 24

Plan health services and other public services

Question 25

Wha data is recorded every 10 years

Answer 25

``` Sex and DOB Marital status Family size Country of birth Employment Housing details - post code for deprivation Car ownership ```

Question 26

What are issues

Answer 26

Under coverage of children / homeless Accuracy Population changes

Question 27

What is Carstairs deprivation

Answer 27

Uses - 1+ person in a room - No car - Male unemployment - Low social class Lower score = more affluent

Question 28

What is Scottish Index of Multiple Deprivation

Answer 28

Data from a wider range of sources Used to target policies to greatest need Divide Scotland into data zone Lower score = more deprived

Question 29

What domains

Answer 29

``` Health Geographic access to services Employment and income Housing and crime Education, skills and training ```

Question 30

When are births recorded

Answer 30

Within 6 weeks

Question 31

How are deaths recorded

Answer 31

Qualified informant, doctor and local registry involved | Info should be accurate but age, occupation or specific cause can be inaccurate

Question 32

What type of morbidity data is there

Answer 32

``` Notfiable disease Hospital activity data Disease registers Specific survey Primary care data ```

Question 33

What are notifiable disease

Answer 33

Report to health protection team in NHS board

Question 34

What is hospital activity data

Answer 34

All discharges and care received

Question 35

What are disease registers

Answer 35

Specific diseases e.g. cancer | Can monitor change in incidence and survival

Question 36

What does primary care data look at

Answer 36

GP consultation Prescribing Practice size Quality and Outcomes Framework

Question 37

What is a CHI

Answer 37

Register with all Scottish residents registered with a GP