Social Medicine State Exam Essays
Definition of Social Medicine
Definition of Medical demography
Health service - structure
Fifteen. Healthcare systems - types.
Twenty-four. Methods of sociological investigation in medicine. Interview. Documents review.
Twenty-five. Social history of the patient. Family anamnesis.
Thirty-three. Medico-social issues of women and maternal care. Maternal Health Programme of National Health Insurance Fund.
One. Social medicine - definition, history, objectives, tasks, and methods.
WHO's definition of health
Social Medicine as a science
History of Social Medicine
History of Social Medicine in Bulgaria
Objectives of Social Medicine
Methods of Social Medicine
What is the difference between Clinical Medicine and Social Medicine?
What is the aim of social medicine specialists?
What is the difference between clinical specialities and non-clinical specialities?
Definition of Social aetiology
Mechanisms whereby social factors have a negative impact
Definition of Social prophylaxis
Goal of Social prophylaxis
Definition of Social therapy
Definition of Social rehabilitation (of disease)
Who fulfils the role of social rehabilitation of patients?
Give me one example of social rehabilitation of a disease?
WHO's definition of health
Classification of Social factors (of health and disease)
The impact of social factors onto health can be categorized into:
Mechanisms whereby social factors have a negative impact
Criteria of health and disease
Definition of individual health
Components of individual health
Factors of individual health
Two. Patient family background (type of family).
Four. Patient social environment
Social determinants of health
Four. Group and public health - definition. Indicators. Health indicators.
Definition of Public health
Indicators (Determinants of Public health)
Definition of Acceleration
Theories of Acceleration.
Indices used to evaluate Acceleration (measures of development).
Social problems with Acceleration.
Five. Medical demography - history, classification. Demographic transition model.
Role of Medical demography.
Definition of Demography.
Definition of Population.
History of Medical demography.
b. Types of Population static.
c. Main instrument of population static.
Two. Population dynamic (period of time) = changes of population.
b. Source of demographic data for Population dynamics:
Demographic Transition Model.
Stage two - High fertility, declining mortality (industrializing).
Stage three - Declining fertility, low mortality.
Stage four - Low fertility, low mortality (stable population).
Stage Five - Low fertility, low mortality
Examples of Social stages of different nations
• What is population count?
What is population structure composition according to?
What are the principles for national censuses, based on United Nations recommendations?
What are the type of errors in demographic data? •
• Demographic indicators for Bulgaria (twenty eighteen)
• Six. Medical demography. Population dynamics. Migration: types and health aspects.
• Role of Medical demography
• Source of demographic data for Population dynamics
• Examples of Population dynamics
• Health aspects (impact on health care and public health) of Migration
• Problems that may occur
• Birth, death, and migration are expressed how in the demographic balancing equation?
• Definition of Medical demography
• Role of Medical demography
• Definition of Demography
• Definition of Population
Source of demographic data for Population dynamics
Examples of Population dynamics
Demographic balancing equation
Requirements for vital registrations
Additional items for registration:
Indicators related to Natural and Vital Events
Factors influencing Birth rate
Birth rate is calculated in several ways:
Population counts from a census
Scale of Assessment for Crude Birth Rate
Indicators related to Birth
Factors influencing Death Rate
Scale of Assessment for Crude mortality Rate
Indicators related to Infant Mortality
Differences in Incidence and Prevalence
Sources for studying the incidence
Main indicators of Morbidity
Methods of collecting morbidity statistics
Active method (where medical professionals actively collect data through):
International Classification of Diseases
The International Classification of Diseases:
International Classification of Diseases eleven Chapters for Mortality and Morbidity Statistics
Nine. Physical development and activity. Acceleration.
Definition of Acceleration
Indices used to evaluate Acceleration (measures of development)
Social problems with Acceleration
Ten. Epidemiology - definition, tasks, methods. Natural history of the disease.
Natural history of the disease
Eleven. Risk factors, causality. Bradford Hill's criteria. Measurement of diseases and exposure. Risk assessment.
Four possible relationships between cause and effect (Causal relationships)
One. Strength of the association:
Three. Specificity of the association:
Five. Biological gradient:
Measurement of diseases and exposure
Example of Risk Assessment
Twelve. Epidemiological studies - observational studies.
• Analytical studies (has control or comparison group)
· Advantages of case reports:
• Disadvantages of case reports:
• Advantages of ecological studies:
• Disadvantages of ecological studies:
• Cross-sectional studies can be:
· Advantages of cross-sectional studies:
• Disadvantages of cross-sectional studies:
• Risk assessment Indicators
• Advantages of case-control studies:
• Disadvantages of case-control studies:
• Risk assessment Indicators
Cohort studies (follow-up)
· Advantages of cohort studies:
• Disadvantages of cohort studies:
• Risk assessment Indicators
• Three main types of bias
Thirteen. Epidemiological studies experimental studies.
• Randomised control trials
Randomised Clinical Trial (R C T)
• Disadvantages of R C T:
• Advantages of field trials:
Intervention trials controlled trials
Nature of Health policy includes
Health policy - Structure
Steps for building a health policy involve:
Health policy - principles
Levels of health services
Health service - structure
Fifteen. Healthcare systems - types.
Types of Healthcare systems
Funding for Healthcare systems
Healthcare service funding
Sixteen. Health policy and reforms in Bulgaria. National health strategy.
National Health Strategy (NHS)
National Health Strategy - objectives
National Health Strategy - priorities
Seventeen. Health legislation in Bulgaria. Health Act.
Structure of the legal norm
Liability of doctors (dismissal, fine, sanction, deprivation of the right to practice, imprisonment)
National System of Healthcare
Management of the national healthcare system
Healthcare establishments.
Health protection activities.
Palliative medical includes.
Medical Aid in an Emergency.
Other things covered in Health Act.
Structure of the legal norm.
Liability of doctors (dismissal, fine, sanction, deprivation of the right to practice, imprisonment).
Health care Establishments Act.
Types of Medical Healthcare Establishments.
Nineteen. Health legislation in Bulgaria. Health Insurance Act.
Structure of the legal norm.
Liability of doctors (dismissal, fine, sanction, deprivation of the right to practice, imprisonment)
Types of Health Insurance
Obligatory Health Insurance
Principles of Obligatory Health Insurance
Rights of those with Obligatory Health Insurance
National Health Insurance Fund
National Health Insurance Fund pays for
The National Frame Contract contains
Chapters of the Health Insurance Act
Chapter Two. Compulsory Health Insurance
Chapter Three. Voluntary Health Insurance
Chapter Four. Medical Control
Twenty. International collaboration for Global Public Health. WHO. Programs and priorities.
WHO regions and regional office
WHO Global Strategy "Health For All"
European Programme of Work
Twenty-one. European Union Health policy. Programs and priorities.
Institutions and bodies of the EU, related to healthcare
Commission's health priorities
Health legislation of the EU
Aims of EU4Health programme:
Communicable Diseases Department (CDS)
Family Health, Gender and Life Course (FGL)
Twenty-two. Health culture and health behaviour. Health education - basic principles, methods, and forms.
Significance of Health Culture and Health Behaviour
Health Education - basic principles
Health Education - methods
Health Education - forms (of organisation)
o Characteristics of Self-Empowerment model:
• Collective Action Model
o Characteristics of Collective Action model:
Twenty-three. Methods of sociological investigation in medicine. Questionnaire. Observation.
Methods of sociological investigation in medicine
Designing the Questionnaire
Requirement of Questionnaire structure
Six. Questions that should be avoided:
Seven. Level of wording should correspond to respondents
Basic requirements of Questionnaire content
Self-Administered Questionnaire (SAQ)
o Advantages of Direct Group SAQ
o Disadvantages of Direct Group SAQ
o Advantages of Direct individual SAQ
o Disadvantages of Direct individual SAQ
Main roles the observer may take
• Non-participating observation
o Advantages of Non-participating observation
Disadvantages of Non-participating observation o
· Participant observation (fieldwork)
o Advantages of Participating observation
o Disadvantages of Participating observation
. According to who makes the observation
▪ Advantages of Self-observation
Disadvantages of Self-observation
▪ Advantages of Self-observation
· Disadvantages of Self-observation
. According to the setting of observation
. According to the use of instrumentation
o Observation using instrumentation
• Medical sociologists study:
Twenty-four. Methods of sociological investigation in medicine. Interview. Documents review.
Methods of sociological investigation in medicine
• Documents review (documents from and concerning the investigated subject)
Structured interview (direct, formal, guided)
▪ Advantages of Structured interviews
Disadvantages of Structured interviews
o Unstructured interview (non-directive, informal, open-ended)
▪ Advantages of Unstructured interviews
Disadvantages of Unstructured interviews • Time-consuming
o Semi-structured interview
According to the number of interviewees
According to the number of meetings (between interviewer and interviewees)
. According to the methods of conducting interview
▪ Advantages of Face-to-face interviews
Disadvantages of Face-to-face interviews
o Interview with distance means of communication (telephone)
▪ Disadvantages of Telephone interviews
Stages of interview process
Examples of Document Review in medicine
Twenty-five. Social history of the patient. Family anamnesis.
General history has seven parts