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STATISTICAL STUDY METHOD

LESSON PURPOSE: To familiarize students with the sequence of statistical research, to teach self-planning and statistical research program, the correct determination of the unit of observation and accounting signs, to familiarize with the methodology of collecting material for its processing and analysis.

LESSON TECHNIQUE At the beginning of the lesson, the teacher gives a definition of health statistics, emphasizing the importance of statistical research for the study of public health and healthcare, medical science and the practice of doctors. Next, a methodology for conducting a statistical study of its main stages is analyzed. With specific examples, the teacher shows that, first of all, it is necessary to clearly formulate the purpose of the study, its tasks, draw up a plan and program for statistical research. A definition of the unit of observation, accounting features to be registered is given, samples of statistical registration documents are shown. After that, the conditions for grouping and summarizing statistical material into tables are analyzed: simple, group, combinational. In the presentation of the second stage of the statistical study, students are introduced to the methods of collecting statistical material, with particular attention to paying attention to the requirements for selective statistical observation. Students carry out the development and summary of statistical material on their own, on the basis of already prepared accounting documents: a card of the patient who has left the hospital, an outpatient's coupon, and a history of a dental patient. The data obtained are graphically displayed and analyzed. At the end of the lesson, the control of completed individual tasks is carried out with a review of the mistakes made by students.

CHECK-UP QUESTIONS

1. What does health statistics study?

2. What are the main stages of a statistical study.

3. What questions do the statistical research plan include?

4. How to create a statistical research program?

5. What is a unit of observation?

6. What is the difference between simple, group and combination tables.

7. What is the procedure for the development and summary of statistical material?

SUMMARY OF TOPIC:

Statistics is a social science that studies the quantitative side of mass social phenomena inextricably linked with their qualitative features. Analysis of quantitative indicators allows us to identify the most important patterns of various processes in the life of society and thus learn about the qualitative nature of phenomena in their relationship. The statistical method has found application in all areas of human activity, in science, including medicine and healthcare. Medical (sanitary) statistics study the state of public health and healthcare, establish the reliability of the results of studies conducted in clinics and laboratories, the effectiveness of new drugs, methods of diagnosis and prevention, the quality of the doctor’s work. The following sections of medical statistics are distinguished: 1) public health statistics; 2) health statistics; 3) statistics of scientific research, or theoretical medical statistics.

Medical and statistical studies are performed in a specific sequence. At the beginning, the goal and objectives of the work are determined. The goal establishes the direction of the entire study as a whole and answers the question "why" it will be conducted. The purpose of medical and social research can be the study of various aspects of public health, the activities of the health system, etc. Tasks determine specific ways to achieve the goal, allow you to divide all the work into steps, overcoming of which contributes to the final result. In the future, a statistical study is carried out in stages, a strict sequence in the implementation of which ensures the completeness and reliability of medical and statistical information.

BASIC STAGES OF STATISTICAL RESEARCH:

1. Preparatory (organizational) stage: drawing up a plan and research program;

2. Collection of statistical material;

3. Development and summary of the material,

4. Analysis of the data, conclusions, suggestions.

The STATISTICAL STUDY PLAN includes a list of organizational issues:

1. Determination of the place (territory) where the study will be conducted - administrative territory, city, district, medical institution, industrial enterprise

2. Determining the time of the study - specific terms of work, taking into account the time required for the collection, statistical processing and analysis of the material. The terms of work can vary from several years to a year, a month, a quarter, which depend on the purpose of the study, the cyclical nature of the phenomena studied, development trends, and seasonality.

3. Determining the type of statistical observation - one-time, current.

A single observation, like a photograph, registers a phenomenon at a certain point in time. An example of a one-time observation is the census, which is carried out throughout the country for one day; the results of a survey of students on a routine examination. Most of the laboratory and instrumental studies are one-time.

Current observation - resembles filming and characterizes the phenomenon by recording signs over a period of time. An example would be the registration in the registry office of births, deaths, marriages, divorces, as well as the registration of diseases in medical institutions. These processes proceed continuously, their sizes are different for different periods of time, and therefore the study of fertility, mortality, morbidity, etc. requires continuous monitoring. This is achieved by organizing continuous ongoing registration, and only subsequently during statistical processing all material can be distributed over specific time periods (year, quarter, month).

4. The definition of the method of statistical observation is continuous, selective. Continuous observation - all units constituting the phenomenon are examined and recorded, without exception. Continuous observation will provide comprehensive information about the phenomenon being studied and is used in cases where an exact reproduction of reality is required or it is necessary to know the total size of the whole phenomenon (taking into account infectious diseases, population censuses). The organization of continuous research is extremely complex and cumbersome, requires large material costs and the participation of a large number of performers, and the development of continuous observation materials takes a long time. Therefore, in those cases when it is necessary to obtain data in a relatively short period of time and at low cost of effort and money, they resort to the selective method. The selective method allows you to cover part of the studied population with the study. With a properly organized sampling, the results obtained on the selected part can be almost completely transferred to the whole phenomenon, i.e. have sufficient representativeness. Conducting a sample study requires the calculation of the required number of observations using special formulas that are based on probability theory (Appendix 2).

5. Determination of the organizers and participants of the study, in small-scale studies, the researcher performs all the work of collecting and processing material himself, and for large-scale studies, the number and qualification of performers, the division of their labor

6. Determination of the funds necessary for the work. A cost estimate is made, the necessary devices, reagents, equipment are purchased.

STATISTICAL STUDY PROGRAM

1. The definition of the unit of observation is an integral part, the primary element of the statistical population, endowed with all the signs that are subject to registration and study. When studying the birth rate, it will be every case of birth in a certain territory for a certain period of time, while studying the incidence - each case of a disease or a sick person. The choice of unit of observation is determined by the purpose and objectives of the study.

2. Definition of accounting features to be registered for each observation unit. Accounting signs can be quantitative - they have a digital expression (age, duration of treatment, length of service, frequency of nutrition) and attributive - are descriptive (gender, profession, outcome of treatment, season). By the role of signs in the aggregate, they can be factorial (influencing) - age, gender, education, sports; and productive (influenced) - growth, body weight, recovery, death.

3. Definition of registration forms subject to accounting.
In hospitals, operational medical documents often serve as registration forms. For example, to take into account the composition of hospitalized patients, the “Outpatient Card” is used, where information about patients and their treatment outcomes are entered in a schematic form, and the “Outpatient Card” is used to study the incidence rate. These documents can be used for statistical purposes after they have played their main role. Other documents used in medical institutions (medical history, outpatient medical records, child development history, dental patient medical history), strictly speaking, are not statistical documents. For the statistical development of these documents, the necessary information from medical records, which are copied onto specially prepared statistical cards and subsequently processed. A registration form can also serve as a questionnaire that allows you to obtain objective information about the personal, intimate aspects of life (relationships in the family, at work, the presence of bad habits, etc.)

4. Drawing up models of statistical tables. By their construction, the tables are divided into simple, group and combination. Each table should have a short title that speaks of its contents. The bottom horizontal row and the last vertical column summarize the work of the graphs and rows. The table should not have empty cells (if there is no sign - a dash is put). The statistical tables distinguish between the subject - the main feature of the phenomenon being studied, and the predicate - accounting features that characterize the subject. A simple table (table No. 1) has a subject and one predicate, it is used to generalize the level and structure of the phenomenon without taking into account causal relationships.



Table number 1.

Distribution of patients who consulted a doctor by nosological forms of diseases



The group table (table. No. 2) of the subject is characterized by several predicates, but the signs characterizing the subject are not interconnected.

Table number 2.

Distribution of patients who consulted a doctor according to nosological forms of diseases, gender, age, social groups



The combination table (table. No. 3) provides more opportunities for analysis, has subject and several interrelated predicates. From the data of the combinational table you can always build a group and a simple table, the opposite is impossible.

Table number 3.

Distribution of patients who consulted a doctor according to nosological forms of diseases, gender, age



The second stage of the statistical study is the collection of material. The objective of this stage is to register each observation unit, its accounting features in strict accordance with the monitoring program and fill out accounting documents.

The third stage is the development and summary of data. At this stage, quality control of the completed accounting documents is carried out (all defects in filling in statistical cards must be corrected, and if this is impossible, the documents are excluded from further development), grouping and summary of the collected material are carried out. Under the grouping is understood the distribution of statistical material into homogeneous groups according to one or several criteria. In medical and social research, various groups are used according to socio-demographic characteristics (age, gender, marital status), by climatogeographic characteristics (season, place of residence), by socio-economic characteristics (profession, position, education, income), by state of health (ICD classes, risk groups, health groups), etc. A summary of the material in the statistical tables allows you to systematize the initially collected data, convert individual facts into a quantitative characteristic of the statistical population as a whole and by main characteristics.

The fourth stage is the analysis of the data, conclusions, suggestions. The task of the fourth stage of the statistical study is to calculate the derived values ​​(relative, average) based on the absolute numbers obtained as a result of their summarization in tables, and a graphical representation of the indicators. In some cases, absolute values ​​can also be subjected to statistical analysis. The results of the data summary are subject to quantitative and qualitative analysis, their reliability is assessed, conclusions and suggestions are formulated.

TASK FOR INDEPENDENT WORK

1. To develop and summarize the prepared statistical material in accordance with the goal and research program.

Each student receives an individual assignment, including a description of the purpose and research program, as well as already collected statistical material (cards of the patient who has left the hospital, coupons of an outpatient patient, etc.). To carry out the work, it is necessary: ​​to assess the quality of filling out accounting documents, to group material (to distribute observation units by homogeneous groups), to fill out simple, group and combination tables, graphically display the data obtained, and analyze statistical material.

2. Based on the goal, draw up a research plan and program, develop models of statistical tables, including 5-6 accounting features.

PURPOSE OF THE STUDY:

1. To study the incidence of temporary disability at the Izumrud plant to develop a plan of preventive measures.

2. Find the causes of work-related injuries at the workers of the Auto Trailers factory for carrying out preventive measures.

3. To study the prevalence of diseases of the circulatory system among the urban population in the factors affecting the incidence rate.

4. Conduct a socio-hygienic study of mortality in pancreatitis.

5. Determine the planned number of children depending on the living conditions of the young family.

6. To identify the causes of early neonatal (in the first week of life) mortality of children in order to develop measures to reduce it.

7. Establish the health status of students of the medical academy to develop measures to strengthen it.

8. To study the prevalence and risk factors for early alcoholization of youth.

9. Investigate the medical and social problems of injuries, poisoning and other external causes of mortality in the Stavropol Territory.

10. Establish the prevalence of tuberculosis among the population of the Stavropol Territory and the factors affecting the incidence.

11. To consider the medical and social aspects of the prevalence of alcoholism and drug addiction in modern conditions.

12. To study the prevalence of dental diseases among various population groups and outline ways of prevention.

13. Determine the frequency of stillbirths in urban and rural women, taking into account age, marital status, working conditions and life.

14. Investigate the prevalence and causes of abortion in young women to develop measures to prevent them.

Recommended Reading

• Lisitsyn Yu.P. Public health and healthcare. M, 2002.

• Lisitsyn Yu.P. Social hygiene (medicine) and healthcare organization. Kazan, 1999, p. 260 - 287

• Serenko A.F., Ermakov V.V. Social Hygiene and Health Organization, M, 1984, p. 102 - 113, 168-184.

• Yuryev V.K., Kutsenko G.I. Public health and healthcare. S-P, 2000, p. 164 - 185.

• Zaitsev V.M. et al. Applied Medical Statistics. S.-P., 2003.

• A.M. Merkov, L.E. Polyakov. Sanitary statistics. “Medicine”, 1974.

• Guidelines on social hygiene and healthcare. Edited by Yu.P. Lisitsyna. M.1987.

• E.V. Gubler, A.A. Genkin. Application of nonparametric statistical criteria in biomedical research. L. "Medicine", 1973.

• Public health and healthcare. Ed. V.A. Minyaeva, N.I. Vishnyakova M. “MEDpress-inform.”, 2002.
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