Social Medicine and Organization of Health Care

MINISTRY OF HEALTH OF UKRAINE DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY

WORK EDUCATIONAL PROGRAM ON EDUCATIONAL DISCIPLINE “SOCIAL MEDICINE AND ORGANIZATION OF HEALTH CARE

INCLUDING BIOSTATISTICS” for the 4-year English-speaking students of medical faculty, who undergo a course of studies on specialty 7.12010001 “General medicine”, qualification - doctor

LVIV - 2018 EXPLANATORY NOTE 1. General section. The work program of discipline “Social medicine and organization of health care” for higher medical institutions of education of Ukraine of 3-4 levels of accreditation is worked out for medical speciality 7.12010001 "General medicine" of training direction 1201 "Medicine". The program is worked out in accordance with the following legislative and normative legal documents:  Law of Ukraine “On Education” dated from 01.07.2014, No 1556-VII  Order of Ministry of Education and Science of Ukraine No 47 dated from 26.01.2015 "On peculiarities of formation curricula in 2015/2016 academic year", registered in the Ministry of Justice of Ukraine 04.02.2015 under No 132/26577;  Letters of Ministry of Education and Science of Ukraine dated from 20.01.2015 No 1 / 9-19 "On organization of certification of candidates who are receiving higher education and organization of educational process"; dated from 13.03.2015 No 1 / 9-126 "On peculiarities of organization of the educational process and curricula in 2015/2016 academic year";  Letters of the Ministry of Health of Ukraine dated from 24.03.2015 No 08.01-47 / 8986 and dated from 16.04.2015 No 08.01-47 / 12037 “On approval of adjusted curricula to the degree training of special- ists of the following disciplines 1201 "Medicine" in 1202 and "Pharmacy";  Regulations on the organization of educational process in Danylo Halytsky Lviv National Medical Uni- versity approved by the Academic Council of the University 02/18/2015, Protocol No 1-VR";  Regulations on the independent work of students of Danylo Halytsky Lviv National Medical University dated from 10.24.20, Protocol No 4;  Regulations on the working curriculum of discipline and methodical recommendations concerning its development, Protocol No 2 of 23.04.2015. 2. STRUCTURE AND CONTENT OF EDUCATION WORK PROGRAM 2.1. DESCRIPTION OF CURRICULUM OF DISCIPLINE "Social medicine and organization of health care including biostatistics" for the 4-year English-speaking students of medical faculty of specialty 7.12010001 "General medicine", qualification - doctor Structure of the Number of hours, of them discipline total of Lecture hours Year of Type of eval- hours / lectures Practical Independent work of study uation credits lessons student ECTS Module 1 3 Topical 90/3 10 32 48 4th credit modules Note: 1 credit ECTS – 30 hours Lecture load – 46.6 %; Іndependent work of student – 53.4 %. 2.2. The purpose and tasks of the discipline The aim of study of discipline «Social medicine and organization of health care including biostatistics» is to prepare 4-year students, who would have sufficient amount of knowledge on basics of organization of medical maintenance of the population in terms of functioning of the modern health care system.

• The main tasks of studying the discipline "Social medicine and organization of health care including Biosta- tistics)" are:

 mastering the theoretical foundations, modern principles of evidence-based medicine;  assimilation of theoretical foundations of biostatistics;  calculation and analysis of the main biostatistics indicators and criteria;  mastering the methodological and theoretical bases of formation of statistical aggregates for a more adequate analysis of them;  evaluation of the results of the analysis according to individual criteria and in relation to the factors influencing them;  mastering the theoretical foundations, modern principles, laws and legal principles of public health and the system of its protection;  assimilation of methods for determining and analyzing the main indicators of public health in relation to factors influencing it;  familiarization with the peculiarities and principles of organization and quality of provision of various types of medical care to the population in the context of reforming the health care sector;  elaboration and implementation of the evaluation of health indicators, activities of health care institutions and practicing doctors with the use of relevant statistical techniques learned during the study of biostatistics;  carrying out an assessment of the quality of medical care;  working out options for managerial decisions aimed at improving the health of the population and optimizing medical care. As a result of studying the discipline the student must:  know: - the definition of “Social Medicine and Organization of Health Care and Biostatatics” - as a science and teaching subject and its importance for health practice; - the theoretical foundations, modern principles of evidence-based medicine and biostatistics; - the main organizational elements of statistical research; - the basic biostatistics indicators and criteria; - the basis for the formation of statistical aggregates for further adequate analysis; - theoretical and methodological bases for the analysis of adequate methods for the analysis of statistical results, their evaluation and description in order to formulate substantiated conclusions; - the features of the interpretation of the concept of "health", indicators of population health; - the patterns of formation of the demographic situation, its features in different countries; - the components of medical and social importance of morbidity and methods of its study; - the classification of risk factors, assessment of their possible impact on the health of the population; - the legislative and legal principles of modern health care. - the legal principles of modern health care; - the basic principles and types of medical care for the population, peculiarities of medical provision of various contingents of the population (women, children, workers of enterprises, elderly persons); - the organization and content of the work of medical institutions and doctors of basic specialties (general practitioners, district therapists and pediatricians, obstetricians-gynecologists, emergency medicine physi- cians, etc.);  be able to: o apply the modern principles of evidence-based medicine and the basis of biostatistics in practice; o determine the tactics of organizing statistical research, planning an experiment; o identify the necessary methods for statistical processing of research data; o calculate statistical indicators, parameters of statistical aggregates; o prevent, diagnose and correct statistical mistakes; o determine the methods of graphic representation of the results of statistical analysis; o assess and analyze statistical indicators and parameters of statistical aggregates; o use the applied methods of biostatistics for data analysis; o identify strategies for finding medical information; organization and implementation of meta-analysis; o develop plans for statistical analysis of the activities of a medical institution; o fill in accounting documents for the study of health indicators (demographic, morbidity); o determine and evaluate the health indicators and the activities of health care institutions through the use of relevant statistical techniques learned in the study of biostatistics; o determine and analyze indicators of morbidity: general, infectious, hospitalized, on the most important socially significant diseases, with temporary disability; o assess the indicators of physical development of the population and indicators of disability for the characteristics of health of the population; o analyze the peculiarities of the formation of a healthy lifestyle in separate groups of the population; o interpret the features of medical care to the population; o define and analyze indicators of activity of individual practitioners and medical institutions of different levels of management; o assess the quality of medical care; o develop options for managerial decisions aimed at improving health of population and optimizing medical aid.

2.3. PROGRAM OF EDUCATIONAL DISCIPLINE

Content module 1. Introduction to social medicine, health care organization and biostatistics. Statistical studies and their analysis

THE FINAL GOALS of the discipline: . to master the theoretical foundations, modern principles of social medicine and organization of health care; . to master the theoretical foundations of evidence-based medicine, clinical epidemiology and biostatistics; . to identify and analyze the main biostatistics indicators and criteria; . to master the methodological and theoretical bases of formation of statistical aggregates for further adequate analysis and evaluation of data in dynamics; . to master the theoretical and methodological bases of the analysis of statistical results, their evaluation and description in order to formulate substantiated conclusions; . be able to evaluate and analyze statistical indicators and parameters of statistical aggregates according to individual criteria and in relation to the factors influencing them.

THEME 1. Social medicine and the organization of health care as a science and subject of teaching. The concept and role of biostatistics as the main component of the system of evidence-based medicine, the history of development and importance for health care practice.

Social medicine and organization of health care - a science that studies the laws of public health and its system of protection. The development and formation of social medicine as a science, the value of the work of prominent scientists, representatives of the socio-medical direction in medicine. Concept of system analysis, statistical, demographic, historical, experimental, epidemiological, economic, sociological methods, expert estimation methods, modeling, forecasting. The significance of social medicine for the formation of health care. Definition of the concepts of "biostatistics", "evidence-based medicine", "clinical epidemiology". The main stages of the development of biostatistics. Outstanding scientists and their contribution to the development of biostatistics. Basic principles of evidence-based medicine. Triad of evidence-based medicine. The theory and practice of evidence-based medicine. Evidence-based medicine and the quality of clinical trials. The concept of the final results. Evidence-based medicine and the quality of medical care. Standardization of medical care: clinical protocols, standards and recommendations. The place and role of biostatistics in medical education and the work of a practitioner.

THEME 2. Statistical values in the practical activity of the physician as the basis of the analysis of its activity. Sources of statistical information. Types of statistical data, statistical reporting. Absolute data, relative values, their practical value. Types of relative values, methods of their calculation and methodical bases of application for data analysis. Graphical data analysis methods. Types of diagrams, rules of their construction. Elements and characteristics of the variance series. Average values: their types, methods of calculation, features of use. Types of standardization methods: direct, indirect, reverse. Characteristics of the stages of the method of standardization. The practical significance of the method of standardization. Basic rules for constructing and analyzing dynamic series in the study of the dynamics of medical and biological phenomena. Levels of the series. Types of dynamic series: simple and complex, interval and mo- mentary. The main indicators of the analysis of dynamic series: absolute growth, the rate of growth / decrease, the rate of growth. Selective observation as a source of statistical information. Level of significance of statistical criteria. Average error of average and relative value, confidence interval. Estimation of probability of difference: Student's t-test, method of calculation, its estimation, typical mistakes of use. Doubles and multiple comparisons. Newman-Keuls method, Tukey's test. Substantiation of cases of nonparametric methods of evaluation, their significance. Types of compara- ble populations, their characteristics. Analysis and evaluation of results in related cohorts, criterion of signs, Wilcoxon test. Checking statistical hypothesis for independent samples, Kolmogorov-Smirnov criterion. Analysis of qualitative features. Conjugation tables. Xi-square criterion, its evaluation and practical application. Fischer's exact criterion. Features of using other nonparametric tests: Mann-Whitney, Kruskal-Wallis. The concept of functional and correlation communication. Strength and direction of communication. Types of correlation coefficients. Pearson linear correlation coefficient, its evaluation, characteristic.

THEME 3. Planning and organization of statistical research. Theory and concept of statistical observation, stages of its conduct. Methodological bases, forms and methods of statistical observation and data collection. Preparation of the program and research plan. Collecting and statistically recording data. Working out and compiling of statistical data. Analysis of statistical materials. Typical statistical analysis errors. Statistical tables, their characteristics, types, rules of construction. Methodological bases for reading and analyzing tables.

THEME 4. Relative values (statistical coefficients). Graphical methods of analysis. The notion of statistical indicators, their types, the form of presentation. Absolute data, relative values, their practical value. Types of relative values, the method of their calculation, and the methodological bases of application for data analysis. Concepts and types of structure of medical and biological data, structural changes, peculiarities of their analysis. Graphic methods for data analysis. Types of diagrams, rules of their construction.

THEME 5. Characteristics and analysis of the statistical aggregate. Average values and variations. Average values in clinical and epidemiological studies, their practical significance. Elements and characteristics of variation series. Average values: their types, methods of calculation, features of use. The concept of variation, its meaning. Variability of aggregate parameters, methods of evaluation. Ab- solute variations (amplitude, average square deviation) and relative variations (coefficients of variation and determination), their estimation. Measures of variation, the concept of the laws of distribution, their types, characteristics. Estimation of distribution normality, "odd" variants. The rule of "three sigma", its practical use.

THEME 6. Method of standardization. Problems of comparing statistical indicators in non-homogeneous aggregates. Types of standardization techniques: direct, indirect, reverse. Characteristics of the stages of the standardization method. The formulation of the null hypothesis. Selection and calculation of the standard. Calculation of ex- pected numbers. Standardized score calculator. Checking the null hypothesis, estimating the results. The practical significance of the standardization method.

THEME 7. Dynamic series and their analysis. Basic rules for constructing and analyzing dynamic series in the study of the dynamics of medical and biological phenomena. Levels of the series. Types of dynamic series: simple and complex, interval and mo- mentary. The main indicators of the analysis of dynamic series: absolute growth, the rate of growth / decrease, the rate of growth. The basic techniques of processing the dynamic series to determine the trend. Methods of aligning dynamic series: least squares; variable avarege, averaging on the left and right sides; increase of intervas. Study and measurement of seasonal variations in the ranks of dynamics. Comparison of dynamic rows. Interpolation and extrapolation in the ranks of the dynamics. Prediction based on the extrapolation of dynamic series.

THEME 8. Parametric and nonparametric methods for the estimation and analysis of statistical hypotheses. Selective observation as a source of statistical information. Null and alternative hypotheses. Errors of the first and second kind. Level of significance of statistical criteria. Average error of average and relative value, confidence interval. Estimation of probability of difference: Student's t-test, method of calculation, its estimation, typical mistakes of use. Doubles and multiple comparisons. Newman-Keuls method, Tukey's test. Substantiation of cases of nonparametric methods of evaluation, their significance. Types of compara- ble populations, their characteristics. Analysis and evaluation of results in related cohorts, criterion of signs, Wilcoxon test. Checking statistical hypothesis for independent samples, Kolmogorov-Smirnov test. Analysis of qualitative features. Conjugation tables. Hi-square criterion, its evaluation and practical application. Fischer's exact test. Features of using other nonparametric tests: Mann-Whitney, Kruskal-Wallis.

THEME 9. Analysis of the relationship between the studied parameters of statistical aggregates. Study of the relationship between quantitative variables. The concept of functional and correlation communication. Strength and direction of communication. Types of correlation coefficients. Pearson linear correlation coefficient, its estimation, characteristic. Nonparametric methods of communication estimation -- the Spearman correlation coefficient. Coupled and multiple correlation coefficients. Regression analysis, regression coefficient, regression equation. Using regression analysis to predict.

THEME 10. Risk factors: the method of calculation and risk assessment. The notion of risk factors. Practical use of risk assessment methodology in epidemiological research. Cohort studies and case-control studies. Risk Indicators, methods for their calculation and analysis. Absolute and additional risk. Relative risk, additional population risk. The odds ratio.

Content module 2. Medical and social aspects of demography and morbidity. Methodology for studying demographic indicators and indicators of morbidity.

SPECIFIC GOALS: • to know the definition of demography, its constituent parts; • to understand the patterns of the formation of the demographic situation, its features in Ukraine; • to interpret the factors which influence the reproduction of the population; • be able to fill in the accounting documents for studying the natural population movement; • to determine and analyze indicators of natural population movement; • to explain the medical and social significance of morbidity; • to know the methods of studying morbidity, its types; • to interpret the main trends of morbidity depending on the influence of various factors; • to familiarize with the contents of the main governmental target programs for socially important diseases; • to be able to fill in the registration documents for registration of certain types of morbidity; • to determine and analyze indicators of morbidity: general, infectious, important non-epidemic, hospitalized.

THEME 11. Medical and social problems of public health and methodology of its study.

Target approaches to the definition of "health": general philosophical, individual theoretical, individual practical, population. To understand health as a state of complete physical, mental and social well-being, and not just as absence of illness or physical disadvantages. Health of the population as a conditional statistical concept, its medical parameters: demographic (birth rate, mortality, average life expectancy); physical development; morbidity; disablement; frequency of pre- morphological conditions. Leading groups of factors influencing health indicators: level and lifestyle of people, condition of the environment, biological factors, availability and quality of medical aid. The effect of lifestyle on the health of the population, the dependence of medical indicators on health from factors of different backgrounds. The concept of the quality of life associated with health as a combination of living conditions and state of health, which allows you to achieve physical, mental, social well-being and self-realization.

THEME 12. Medical and social problems of demographic processes and the state of population morbidity. Features of demographic indicators and indicators of morbidity in different regions of the world, individual countries and in Ukraine. Demography as a science. Its componets. Sources of information on the number, composition and population movement. The history of censuses of the population. Dynamics of population and population composition in selected regions of the world and individual countries, in Ukraine. The medical and social significance of this information. The main tendencies inherent to Ukraine and other countries of the world in relation to the process of urbanization, gender and age of the population. Medical and social significance of migration processes. Natural population movement. Regional features of fertility in Ukraine and the modern world. Total mortality, its leading causes in different regions, individual countries and Ukraine. Sexual-age and territorial features of mortality rates. Mortality of infants (infant mortality). The value of the indicator for assessing the health status of the population, the level of socio-economic well-being and the development of society as a whole. Top reasons. Dynamics of infant mortality rate in recent years in Ukraine compared to countries in the European and other regions of the world. Average life expectancy, definition of the concept. The essence of the methodology for determining the indicator, its dynamics in different countries and in Ukraine. The concept of morbidity, the purpose of its study. Medico-social significance of morbidity as the leading cause of temporary and permanent loss of ability to work, mortality. Influence of the morbidity on the needs of providing the population with medical care and on the health of future generations. Methods of studying morbidity, the possibility of using individual methods, their advantages and disadvantages. Application of methods of epidemiological research in the study of non-infectious diseases. Factors influencing the completeness of the data of the morbidity depending on the methods of its study. International statistical classification of diseases, injuries and causes of death, principles of its construction and significance. Types of morbidity studied in Ukraine.

THEME 13. Methodology for studying and evaluating the factors that affect the health of the population.

Methodological approaches to the study of factors that determine the health of the population and its individual contingents. Features of studying the influence of factors of socio-economic, socio-biological, environmental and natural-climatic, medical-organizational. Problems in collecting relevant information. Application of methods and techniques of biostatistics (derivatives and averages, standardization method, correlation-regression analysis, parametric and nonparametric estimation of probability of results of research, score and rating estimation). Compliance with the requirements of evidence-based medicine. Classification of risk factors that affect health.

THEME 14. Methodology for studying and estimating the indicators of natural movement and mortality rates of infants. Documents used to study the natural movement of the population. Possibilities of their application. The order of registration of births in Ukraine. The essence of the concepts of "live birth", "stillbirth", "death of the fetus". Method of determination and estimation of general and special birth rates. Total mortality. The order of registration of deaths in Ukraine. The method of studying mortality, the definition of general and specific indicators, their significance and evaluation. Natural population growth. The order of registration of infant mortality (babys). Method of determination of indicators of general, neonatal, postneonatal mortality of infants. Estimation of correlation of these indicators, types of infant mortality: A.B.C. Perinatal mortality. Infant mortality of boys and girls, seasonal features of infant mortality. The leading causes of infants mortality in different age periods of the first year of life. The main groups of factors that influence the formation of infant mortality (biological, ecological, medical, organizational, lifestyle). Expert evaluation method for mortality in infants.

THEME 15. The method of studying and evaluating the indicators of general morbidity, infectious, non-epidemic and hospitalized. Study of morbidity according to the data of referral for medical aid. Study of general morbidity: unit of observation, accounting documents, rules of their filling. Method of determination of indicators of primary morbidity and prevalence of diseases, their estimation, regional features. Dynamics of indicators of general morbidity. Features of the account of infectious, important non-epidemic, hospitalized. Accounting documents, rules of their filling in. Method of determination of indicators of the specified types of morbidity, their estimation, regional features. Dynamics of indicators of infectious, important non-epidemic, hospitalized morbidity.

Content module 3. Organization of medical and preventive care for the population

SPECIFIC GOALS: • to know the basic principles of medical and preventive care for the population of Ukraine, including family medicine (general practice); • to interpret the legal framework for the organization of medical care, the importance of primary health care (PHC); • to know the types of medical and preventive care; • to interpret the essence of community-based, inpatient and emergency medical care; • to know the basics and features of medical and preventive care for the urban and rural population; • to know the content and organization of work of the general practitioners; • to analyze the expediency of various PHC models in Ukraine; • to know the organization and content of outpatient and inpatient facilities; • to know the organization and content of the work of emergency medical care institutions; • to know the essence and features of medical and social care of the elderly; • to master the theoretical bases, modern principles of palliative and hospice medicine: • learn how to summarize the gained knowledge and interpret their use in future professional activities; • to master the skills and abilities of palliative and hospice care necessary for the professional activity of the doctor. • to formulate the task of the medical examination, the content of the work of all units of the medical establishment on the organization of medical examination of the adult population, children, pregnant women and gyne- cologic patients; • to make conclusions and develop recommendations for improving the organization, quality and effectiveness of clinical examination. • to define and analyze indicators of efficiency of clinical examination. • be able to fill the registration documents of health care institutions; • to define and analyze indicators of activity of outpatient and inpatient institutions, establishments of EMС.

THEME 16. The main constitutional and legislative principles of health care and organization of medical care to the population of Ukraine The Constitution of Ukraine (1996) (Articles: 3, 27, 49). The Law of Ukraine "On ensuring sanitary and epidemiological well-being of the population" (1994) (Articles: 26, 27, 28). The Law of Ukraine "On Amend- ments to the Fundamentals of the Ukrainian Legislation on Health Care for Improving the Provision of Medical Aid" (2011) (Articles: 15, 34, 35, 35-1, 35-2, 35-3, 35-4, 35-5, 38, 39, 39-1, 42, 43, 44).

THEME 17. The organization and content of the work of outpatient institutions of different levels, accounting and analysis of their activities. Tasks and sections of the institutions, its structural subdivisions. Established standards. Functions of the main units. The organization and content of the work of the district therapist, the head of the department (office). The purpose and essence of the clinical examination method, the selection of contingents for clinical examination. Types of preventive examinations, their organization. Stages of medical examination. The main documentation used to record the work of the departments of the clinic, the content and the procedure for filling in: Methodology for calculating and analyzing the indicators of the activity of polyclinic according to the report of the medical and preventive institution (No 20), the report on the number of diseases registered in patients living in the district of the treatment and prevention institution (f. No 12). Development of measures to improve the operation of outpatient institutions.

THEME 18. Content and organization of work of the general practitioner / family doctor, including palliative care and hospice care. Organization of work of general practitioner implemented on the basis of different models. Functions and content of work of the general practitioner in relation to preventive, diagnostic, medical measures, solution of medical and social problems of the family. The organization of collaboration of family general practitioners with paramedical service and social workers. The main accounting documentation of institutions based on family medicine. Determination and evaluation of the performance of general practitioner. Organization of palliative and hospice care for urban and rural population, prospects for its development. Place and role of general practitioner. THEME 19. Organization and maintenance of work of inpatient departments of different levels and permanent establishments, accounting and analysis of their activities. Tasks of hospitals. Structural subdivisions of the hospital and their functions. The order of referral of patients to the hospital. Contents and organization of work of the doctor-resident and head of the department. Factors influencing the rational use of the bed fund and the efficiency of work of the inpatient department. The main documentation used to record the work of the hospital, the content and the procedure for filling in. Method of calculation and analysis of indicators of activity of the inpatient department according to the report of the medical and preventive institution (f. No 20). Types of hospital of replacement institutions. The task, the structure of the day inpatient department. Functions of the day inpatient department and home inpatient care. The order of referral of patients to the day-hospital and at home. The main accounting document of the day hospital and inpatient department at home, the order of its filling in. Methodology of calculation and analysis of indicators of day-care and permanent establishment at home. Development of measures to improve the operation of hospitals and inpatient institutions. THEME 20. Organization of the process of clinical examination, registration and analysis. Prerequisites for clinical examination of the population in Ukraine. The concept and contents of the clinical examination supervision. The purpose of clinical examination of the population. Order of the Ministry of Health of Ukraine dated from 27.08.2010, No 728 "On the clinical examination of the population". The procedure of clinical examination of the population. Management and planning of conducting clinical examination of the population. Organization of work on conducting clinical examination of the population. Method of conducting clinical examination of adult population. Interconnection and consistency in the work of health facilities during the conduction of clinical examination. Accounts receivable documents: "Medical card of the outpatient patient" (f. No 025 / о), "Control card of the clinical examination" (f. No 030/о), "The map of the account of the medical examination" (f. No. 131/o). Requirements for writing epicrisis. Criteria for the effectiveness of the clinical examination of the population.

THEME 21. Organization of emergency medical aid. The contents of the work of the Center of Emergency Medical Care, accounting and analysis of activities. Organization of Emergency Medical Care. The structure of the stations and substations of the EMC of the big city. Types of outbound brigades, their composition, functions. Challenges and departure of brigades: the main reasons. Organization of EMC in the countryside. Interaction of EMC service with different medical institutions. Medical documents of EMC stations, determination and analysis of indicators of their activities. Emergency and Emergency Medicine Centers. Structure, states, tasks and main functions. Task of the station (department) of emergency medical aid (EMD) and its functions. Indicators of service activity. The value of emergency medical care.

2.2.4. STRUCTURE OF EDUCATIONAL DISCIPLINE

MODULE 1: Population Health Statistics. Organization of the main types of medical providing population at its current levels

No Theme lessons lessons ent work entwork Practical Lecrures Lecrures Independ Content module 1. Introduction to social medicine, organization of health care and biostatistics. Statistical studies and their analysis 1. Social medicine and organization of health care as a science and subject of teaching. The concept and role of biostatistics as the main component of evidence-based 2 – 0,5 medicine, history of development and importance for practice of health care. 2. Statistical values in the practical activity of the physician as the basis for the analysis of his 2 – 0,5 activity. 3. Planning and organization of conducting statistical researches. – 2 2,5 4. Relative values (statistical coefficients). Graphical methods of analysis. - 2 2,5 5. Characteristics and analysis of statistical data. Average values and indicators of variation. - 2 2,5 6. Method of standardization. - 2 2,5 7. Dynamic series and their analysis. - 2 2,5 8. Parametric and nonparametric methods for estimating and analyzing statistical hypothe- 2 2,5 ses. 9. Analysis of the relationship between the studied parameters of statistical aggregates. 2 2,5 10 Risk factors. Method of calculation and risk assessment. 2 2,5 Content module 2. Medical and social aspects of health, demography and morbidity. Methodology for studying demographic indicators and indicators of morbidity. 11 Medical and social problems of public health and methodology of its study. 2 - 0,5 12 Medical and social problems of demographic processes and the state of morbidity of the population. Features of demographic indicators and indicators of morbidity in different 2 - 0,5 regions of the world, individual countries and in Ukraine Methodology for studying and evaluating factors which negatively affect the health of the 2,5 13 - 2 population. Methodology for studying and estimating natural movement indicators and infant 14 - 2 2,5 mortality rates. Methodology for studying and evaluating indicators of general morbidity, infectious, non- 2,5 15 - 2 epidemic and hospitalized. Content module 3. Organization of medical and preventive care for the population. The main constitutional and legislative principles of health care and organization of 16 2 - 0,5 medical care to the population of Ukraine Organization and maintenance of the work of the outpatient institutions at different 17 - 2 levels, accounting and analysis of their activities. 2,5 Contents and organization of the work of a general practitioner / family physician, 18 - 2 2,5 including palliative care and hospice care. Organization and content of work of inpatient departments of different levels and 19 - 2 2,5 hospital replacement institutions, registration and analysis of their activities. 20 Organization of the process of clinical examination, registration and analysis. - 2 2,5 Emergency medical care. Contents of the work of the Center of Emergency Medical - 2,5 21 Care, accounting and analysis of activities. 2 Credit - 2 Total hours – 90 10 32 48 ECTS credits – 3 Lecture workload – 46.6%, independent work of student – 53.4%

2.2.5. THEMES OF LECTURES

Number of No Theme hours Content module 1. Introduction to social medicine, organization of health care and biostatistics. Statistical studies and their analysis 1. Social medicine and organization of health care as a science and subject of teaching. The concept and role of biostatistics as the main constituent of evidence-based medicine, history 2 of development and importance for health practice 2. Statistical values in the practical activity of the physician as the basis for the analysis of his 2 activity. Total 4 Content module 2. Medical and social aspects of health, demography and morbidity. Methodology for studying demographic indicators and indicators of morbidity 3. Medical and social problems of population health and methodology of its study. 2 4. Medical and social problems of demographic processes and the state of morbidity of the population. Features of demographic indicators and indicators of morbidity in different 2 regions of the world, individual countries and in Ukraine Total 4 Content module 3. Organization of medical and preventive care for the population. 5. Basic constitutional and legislative principles of health care and organization of medical 2 assistance to the population of Ukraine. Total 2 Number of lecture hours of discipline 10

2.2.6 THEMES OF PRACTICAL LESSONS Number No Тheme of hours Content module 1. Introduction to social medicine, health care organization and biostatistics. Statistical studies and their analysis. 1 Planning and organization of statistical researches. 2 2 Relative values (statistical coefficients). Graphical methods of analysis.. 2 3 Characterization and analysis of statistical data. Average values and indicators of variations. 2 4 Standardization method. 2 5 Dynamic series and their analysis. 2 Parametric and nonparametric methods for the estimation and analysis of statistical hypoth- 6 2 eses. 7 Analysis of the relationship between the studied parameters of statistical aggregates. 2 8 Risk factors. Method of calculation and risk assessment. 2 Total 16 Content module 2. Medical and social aspects of health, demography and morbidity. Methodology for studying demographic indicators and indicators of morbidity. Methodology for the study and evaluation of factors which negatively affect the health of the 9 2 population. Methodology for studying and estimating indicators of natural movement and infant mortality 10 2 rates. Methodology for studying and evaluating indicators of general morbidity, infectious, non- 11 2 epidemic and hospitalized. Total 6 Content module 3. Organization of medical and preventive care for the population Organization and maintenance of the work of the outpatient institutions at different levels, 12 2 accounting and analysis of their activities. Contents and organization of the work of a general practitioner / family physician, including in 13 2 matters of palliative care and hospice care. Organization and maintenance of work of inpatient departments of different levels and 14 2 permanent establishments, accounting and analysis of their activities. 15 Organization of the process of medical examination, registration and analysis. 2 Organization of Emergency Medical Aid. Contents of the work of the Center of Emergency 16 2 Medical Care, accounting and analysis of activities. Total 10 Number of hours of practical lessons of discipline 32

2.2.7. THE INDIVIDUAL WORK OF STUDENTS Number Control No Тheme of hours method Content module 1 Introduction to social medicine, organization of health care and biostatistics. Statistical studies and their analysis Current 1. Clinical epidemiology as a science. Significance for health care practice. 6 control on 2. Evidence-based medicine. 6 practical Total 12 lessons Content module 2. Medical and social aspects of health, demography and morbidity. Methodology for studying demographic indicators and indicators of morbidity Current control on 3. Medical and social problems of demographic processes. 6 practical lessons Total 6 Content module 3. Organization of medical and preventive care for the population. Family medicine and its importance in the system of medical care to the Current 4. 6 population. Content and organization of family doctor / general practitioner. control on Organization of palliative and hospice care to the population and prospects for practical 5. 6 its development. lessons Clinical examination - as a preventive technology in the medical service of the 6. 6 population. Classical organizational and managerial systems of health protection and 7. 6 principles of their functioning. Organizational and legal bases of introduction and functioning of health 8. 6 insurance. Total 30 Total in discipline 48

2.2.8. TEACHING METHODS

А) Traditional classification of teaching methods: B) By appointment (M. Danylov, B.Yesypov): - practical; - acquisition of knowledge; - obvious; - formation of abilities and skills; - verbal; - use of knowledge; - work with the book; - creative activities; - video method. - consolidation; - test of knowledge, abilities and skills. B) By the nature of cognitive activity: B) By the didactic objectives: - Explanatory and illustrative (Informational and recep- - methods that promote initial learning of educational tive); material; - reproductive; - methods that promote the consolidation and - problematic presentation; improvement of acquired knowledge - partly retrieval or heuristic method; - investigative.

2.2.9. METHODS OF CONTROL Previous current іndividual Topical final group

2.2.10. GROUPING OF OBTAINED POINTS BY THE STUDENTS

. Types of control - current and final. . The form of final control according to the curriculum - a credit . Evaluation criteria: A) Current control is carried out on each practical lesson according to the specific goals of topic; it is carried out during individual work of lecturer with the student concerning those themes which the student has been working independently and which are not part of the structure of the workshops, where it is used objec- tive / standardized control of theoretical and practical preparation of students. Evaluation of current educational activity during evaluation of learning of each topic for current educational activity the student gets marks according to the 4-point scale (traditional) scale taking into account the approved evaluation criteria of discipline. Besides, it is taken into account all types of work, provided by the curriculum. The student must get a marr for each topic. Forms of assessment of current educational activity should be standardized and include control of theoretical and practical training. Marks that are put according to the traditional assessment scale are converted into points. B) Exam is a form of final control: The maximum number of points that a student can collect for current educational activity during semester in order to be admitted to the exam is 120 points. The minimum number of points that a student can collect for current educational activity during semester in order to be admitted to the exam is 72 points. Calculating of the number of points is based on obtained marks of student according to traditional scale while learning subject during the semester, by calculating the arithmetic mean (AM) that is rounded to two signs after comma

The resulting value is converted into points by the multi-scale as follows:

AM × 200 Х = 5

Таble 1

Recalculation of the average for current activities in the multi-scale for discipline, ending with a credit

4- 200- 4- 200- 4- 200- 4- 200-

point point point point point point point point

scale scale scale scale scale scale scale scale

5 200 4.45 178 3.92 157 3.37 135

4.97 199 4.42 177 3.89 156 3.35 134

4.95 198 4.4 176 3.87 155 3.32 133

4.92 197 4.37 175 3.84 154 3.3 132

4.9 196 4.35 174 3.82 153 3.27 131

4.87 195 4.32 173 3.79 152 3.25 130

4.85 194 4.3 172 3.77 151 3.22 129

4.82 193 4.27 171 3.74 150 3.2 128

4.8 192 4.24 170 3.72 149 3.17 127

4.77 191 4.22 169 3.7 148 3.15 126

4.75 190 4.19 168 3.67 147 3.12 125

4.72 189 4.17 167 3.65 146 3.1 124

4.7 188 4.14 166 3.62 145 3.07 123

4.67 187 4.12 165 3.57 143 3.02 121

4.65 186 4.09 164 3.55 142 3 120

4.62 185 4.07 163 3.52 141 Less than Not 3 enough

4.6 184 4.04 162 3.5 140

4.57 183 4.02 161 3.47 139

4.52 181 3.99 160 3.45 138

4.5 180 3.97 159 3.42 137

4.47 179 3.94 158 3.4 136

Discipline points are independently converted into both the ECTS and 4-point scale. The ECTS scores on the 4-point scale are not converted and vice versa. Points of students studying in one specialty, taking into account the number of points scored from the discipline, are ranked on the ECTS scale as follows:

Таble 3 Score ECTS Statistical Index А The best 10 % of students

В The next 25 % of students С The next 30 % of students

D The next 25 % of students E The last 10 % of students

Score points for students who have successfully completed the program are converted into the traditional 4-point scale by the absolute criteria listed in the table below:

Таble 4 Points Grade on discipline by the 4-point scale

from 170 to 200 points "5" from 140 to 169 points "4" from 139 points to the minimum number of "3" points to be scored by the student below the minimum number of points to be "2" scored by the student

The ECTS mark by the traditional scale is not converted, because the ECTS scale and the four-point scale are independent. Objectivity of assessment of educational activity of students is checked by the statistical methods (correlation coefficient between ECTS assessment and national scale assessment).

2.2.11. METHODOLOGICAL SUPPORT

А) Textbooks and manuals 1. Moskalenko V. F., Gulchii O. P., Golubchikov M. V., Ledoschuk B. O., Lekhan V. M., Ogniev V. A., Litvinova L. O., Maksimenko O. P., Tonkovyd O. B. Biostatistics / Under the editorship of the Corresponding Member of the Academy of Medical Sciences of Ukraine, Professor V. F. Moskalenko - Kyiv, 2009. - 184 p. 2. Social Medicine and Organization of Health Care / Ed. by Yu. V. Voronenko. – Ternopil, 2000. – 680 p. 3. Program test questions on social medicine and health care organization / Ed. by Yu. V. Voronenko. - Second Edition. - Ternopil: "Ukrmedknyha". – 316 p. 4. Laws of Ukraine on health care (a collection of normative legal acts) / Ed. by V. F. Moskalenko, V. V. Kostitskyi. — Ternopil: "Ukrmedknyha", 2000. — 464 p. 5. Manual on social medicine and health care organization (training manual for students of higher medical educational institutions of 3-4 accreditation levels) / Ed. by Yu. V. Voronenko. - K.: Health, 2002. - 360 p. 6. Program test questions on social medicine and health care organization (training manual for students of higher medical educational institutions of 3-4 accreditation levels) / Ed. by Yu. V. Voronenko. – Kyiv, 2001. – 316 p. 7. Social medicine and health care organization (workshop: a training manual for students of higher educational institutions of the 1-4 levels of accreditation on specialty "Nursing" educational-qualification level "Specialist", "General medicine", "Bachelor") / Ed. by Yu. V. Voronenko, V. V. Ruden. - Lviv: New World. - 2000, 2004. - 375 p. – 2000, 2004. – 375 p. 8. Social medicine and healthcare organization (workshop: a training manual for students of higher educational institutions of the 1-4 levels of accreditation on specialty "Nursing" educational-qualification level "Specialist", "General medicine", "Bachelor") / Ed. by Yu. V. Voronenko, V. V. Ruden. - Lviv: New World. – 2000, 2007. – 375 p.

B) Methodical recommendations 1. Ruden V. V., Gutor T. G. Methodical bases of the organization of statistical research in the system of health care. Methodical development of independent work for the practical lessons on the educational discipline "Biostatistics" for students of the 4-year of the medical faculty / V. V. Ruden, T. G. Gutor. – Lviv: OD KSM, 2008. – 12 p. 2. Ruden V. V., Kozii-Bredelieva S. P. Relative values (statistical coefficients). Graphical methods of analysis. Methodical development of independent work for the practical lessons on the educational discipline "Biostatistics" for students of the 4-year of the medical faculty / V. V. Ruden, S. P. Kozii-Bredelieva. – Lviv: OD KSM, 2008. – 11 p. 3. Ruden V. V., Gutor T. G. Risk factors. Method of calculation and risk assessment. Methodical development of independent work for the practical lessons on the educational discipline "Biostatistics" for students of the 4-year of the medical faculty / V. V. Ruden, T. G. Gutor. – Lviv: OD KSM, 2008. – 12 p. 4. Ruden V. V., Yakhno G. G. Method of standardization. Methodical development of independent work for the practical lessons on the educational discipline "Biostatistics" for students of the 4-year of the medical faculty / V. V. Ruden, G. G. Yakhno. – Lviv: OD KSM, 2008. – 6 p. 5. Ruden V. V., Tsitsko M. V. Dynamic series and their analysis. Methodical development of independent work for the practical lessons on the educational discipline "Biostatistics" for students of the 4-year of the medical faculty / V. V. Ruden, M. V. Tsitsko. – Lviv: OD KSM, 2008. – 8 p. 6. Ruden V. V., Tsitsko M. V. Characteristics and analysis of statistical data. Average values and indicators of variation. Methodical development of independent work for the practical lessons on the educational discipline "Biostatistics" for students of the 4-year of the medical faculty / Ruden V. V., Tsitsko M. V. – Lviv: OD KSM, 2008. – 9 p. 7. Ruden V. V., Olishchuk V. V., Gutor T. G. Parametric methods of the estimation and analysis of statistical hypotheses. Methodical development of independent work for the practical lessons on the educational discipline "Biostatistics" for students of the 4-year of the medical faculty / V. V. Ruden, V. V. Olishchuk, T. G. Gutor. – Lviv: OD KSM, 2008. – 5 p. 8. Ruden V. V., Olishchuk V. V., Gutor T. G. Nonparametric methods of the estimation and analysis of statistical hypotheses. Methodical development of independent work for the practical lessons on the educational discipline "Biostatistics" for students of the 4-year of the medical faculty / V. V. Ruden, V. V. Olishchuk, T. G. Gutor. – Lviv: OD KSM, 2008. – 9 p. 9. Ruden V. V., Yakhno G. G. Analysis of the relationship between the studied parameters of statistical aggregates. Methodical development of independent work for the practical lessons on the educational discipline "Biostatistics" for students of the 4-year of the medical faculty / V. V. Ruden, G. G. Yakhno. – Lviv: OD KSM, 2008. – 10 p. 10. Ruden V. V., Gutor T. G. A methodology for studying and evaluating the factors which affect the health of the population. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty/ V. V. Ruden, T. G. Gutor. – Lviv: OD KSM, 2009. – 14 p. 11. Kozii-Bredelieva S. P. Methodology of study and evaluation of natural movement. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / S. P. Kozii-Bredelieva. – Lviv: OD KSM, 2009. – 12 p. 12. Kozii-Bredelieva S. P. Methodology of study and evaluation of infant mortality. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / S. P. Kozii-Bredelieva. – Lviv: OD KSM, 2009. – 17 p. 13. Tsitsko M. V. Methodology of study and evaluation of indicators of of general morbidity. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / M. V. Tsitsko. – Lviv: OD KSM, 2009. – 19 p. 14. Yakhno G. G. Methodology of study and evaluation of indicators of infectious, important non- epidemic and hospitalized incidence. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / G. G. Yakhno. – Lviv: OD KSM, 2009. – 22 p. 15. Diachyshyn V. I., Gutor T. G. Organization and content of the work of outpatient institutions of different levels, accounting and analysis of their activities. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / V. I. Diachyshyn, T. G. Gutor. – Lviv: OD KSM, 2009. – 36 p. 16. Ruden V. V. Organization and content of work of inpatient departments of different levels, accounting and analysis of their activities. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / V. V. Ruden. – Lviv: OD KSM, 2009. – 22 p. 17. Ruden V. V., Kozii-Bredelieva S. P. Organization and content of work of hospital replacement institutions. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / V. V. Ruden, S. P. Kozii-Bredelieva. – Lviv: OD KSM, 2009. – 16 p. 18. Ruden V. V., Gutor T. G. Content and organization of work of family doctor / general practitioner. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / V. V. Ruden, T. G. Gutor. – Lviv: OD KSM, 2009. – 15 p. 19. Ruden V. V. Organization of work of medical and preventive institutions at various stages of medical provision of rural population. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / V. V. Ruden. – Lviv: OD KSM, 2009. – 14 p. 20. Ruden V. V., Gutor T. G., Kozii-Bredelieva S. P. Organization of ambulance. Content of the work of the ambulance stations, accounting and analysis of their activities. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / V. V. Ruden, T. G. Gutor, S. P. Kozii-Bredelieva. – Lviv: OD KSM, 2009. – 7 p. 21. Ruden V. V., Kozii-Bredelieva S. P., Zaremba N. I., Gupalo I. V. Organization, content, registration and analysis of the process of medical examination by the doctor of the primary level of medical provision. Content of ambulance stations, accounting and analysis of their activity. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / V. V. Ruden, S. P. Kozii-Bredelieva, N. I. Zaremba, I. V. Gupalo. – Lviv: OD KSM, 2013. – 39 p. 22. Ruden V. V., Kozii-Bredelieva S. P., Zaremba N. I. Organization, the content of the work of the emergency medical aid, accounting and analysis of its activities. Methodical development of independent work for the practical lessons on the educational discipline "Social medicine and health care organization" for students of the 4-year of the medical faculty / V. V. Ruden, S. P. Kozii-Bredelieva, N. I. Zaremba. – Lviv: OD KSM, 2014. – 58 p.

2.2.12. LIST OF QUESTIONS FOR CURRENT CONTROL Content module 1. Introduction to social medicine, organization of health care and biostatistics. Statistical studies and their analysis. 1. Social medicine and health care as a science. Basic methods. History of development. 2. Medico-social studies of the 19th and early 20th centuries. 3. The development of social medicine in the writings of Ukrainian scholars of the twentieth century: O. Korchak-Chepurkivsky, S. Kagan, Z. Gurevych, S. Tomilin, L. Lekarev, I. Horosha, G. Lukyanova, O. Granto. 4. The theory and concepts of statistical observation, stages of its conduct. 5. Design of clinical research. Sources of statistical information. 6. Design of clinical trials. Control group. Blindness study 7. Types of clinical research design. Ethics of research. 8. Required sample size. Criteria for inclusion and exclusion. 9. Selection of the object of research, the concept of randomization and stratification. 10. Grouping statistics. Types of groupings. Encoding and encrypting statistics. 11. Statistical tables, their characteristics, types, rules of construction. 12. Selective observation as a source of statistical information. Sample requirements. 13. Types of statistical observation of time. Prospective and retrospective studies. 14. Types of statistical monitoring of the completeness of accounting. Concept of general and sample aggregate. 15. Methods of collecting statistical material. Rules for composing questionnaires. Open and closed questions. 16. Absolute data, relative values, their practical value. 17. Graphical data analysis methods. Types of diagrams, rules of their construction. 18. The ratios and visibility indicators, the method of their calculation and the methodological bases of application for data analysis. 19. Intensive and extensive indicators, methods of their calculation and methodical bases of application for data analysis. 20. Medium values in clinical and epidemiological studies, their types, practical value, methods of calculation. 21. The concept of variation, its meaning. Variability of aggregate parameters, methods of evaluation. 22. Indicators of variation: mean square deviation, coefficient of variation. 23. Normal distribution of numbers. The rule of three sigmas. The amplitude of the variation series. 24. Analysis and evaluation of results in related cohorts, criterion of signs, Wilcoxon criterion. 25. Inspection of the statistical hypothesis for independent samples. Criterion of conformity of Xi-square, its estimation and practical application. 26. Substantiation of cases of nonparametric methods of estimating probability, their significance. 27. Estimation of the probability of difference: Students criterion, method of calculation, its estimation, typical mistakes of use. 28. Average error of average and relative value, confidence interval. 29. Functional and correlation communication. Types of correlation coefficients. 30. Correlation-regression communication. Direction and strength of communication. 31. Correlation-regression communication. The pair and multiplicity of the correlation coefficients. 32. Regression analysis, regression coefficient, regression equation. Using regression analysis to predict. 33. The coefficient of linear correlation, its estimation, characteristic and features of use. 34. Ratio correlation coefficient, its estimation, characteristic and features of use. 35. Standardization methods, stages of direct method of standardization. 36. The practical significance of the standardization method, the assessment of standardized indicators. 37. Stages of the direct method of standardization. Rules for selecting and calculating the standard. 38. Types of dynamics series. Basic rules for constructing and analyzing dynamic rows. Aligning dynamic rows. The method of moving average. 39. Aligning Dynamic Rows. Averaging method on the left and right halves. 40. Basic indicators of analysis of dynamic series. Method of calculation and evaluation. 41. Analysis of the dynamics of medical and social phenomena for further prediction, the concept of extrapolation and interpolation. 42. The concept of risk in epidemiological studies. The concept of risk factors. The main risk factors influencing public health. 43. Indicators of absolute and relative risk, the method of their calculation and analysis. 44. The concept of a chance in epidemiological research. Indicator of the ratio of odds, method of calculation and analysis. 45. Clinical epidemiology. Basic principles and regulations. Hierarchy of Evidence of Clinical Research. 46. The notion of a null hypothesis. Checking statistical hypothesis. Errors of the first and second kind. 47. Screening. The main characteristics of screening tests. Specificity and sensitivity of the screening test. 48. Empirical and experimental epidemiological studies. Cohort studies and case-control studies. 49. Evidence-based medicine. History, main provisions, areas of application. Triad of evidence-based medicine. Cochrane Cooperation. 50. Types of data. Concept of measurement scale. Metadata The concept of systematic reviews and meta- analysis. 51. The subject and tasks of medical statistics. Organization of the medical statistics service in Ukraine. The task of the information and analytical department of the health care institution. The concept of accounting and accounting documentation. Content module 2. Medical and social aspects of health, demography and morbidity. Methodology for studying demographic indicators and indicators of morbidity.

1. Targeted approaches to the definition of "health". 2. Health indicators of the population. 3. Leading groups of factors influencing public health. Features of the study of the influence of factors of different origins on the health of the population. Compliance with the requirements of evidence-based medicine. 4. Classification of risk factors that affect health, the method of their study. 5. Health care systems in the modern world, their features. 6. Principles for the development of national health systems in accordance with WHO recommendations. 7. Basic principles of health protection in Ukraine. 8. Citizens' rights to health care, their duties. 9. The rights and social protection of health workers. 10. Subject and content of demography, the meaning of demographic data for health practice. Changes in the size and composition of population of different regions of the world and countries of Ukraine in recent years. 11. Methods of studying the natural population movement, sources of information, indicators. 12. Fertility, its level in Ukraine. Factors influencing the birth rate. 13. Mortality. Methodology for calculation of general and special indicators. Features and causes of mortality in different groups of the population. The dynamics of this indicator in different regions, individual countries and Ukraine. 14. Mortality of infants, age-specifics. The leading causes, factors that influence its formation. Medical and social aspects of reducing infant mortality. 15. The average life expectancy (ALE), the relationship with the Human Development Index (IDLP). Trends in the dynamics of ALEs in selected regions of the world, countries and Ukraine. Taking into account the impact of the "burden of disease" on STOP. 16. The concept of morbidity, its medical and social significance. 17. Methods of studying morbidity. Advantages and possibilities of different methods. Factors and conditions that affect the completeness of data on the incidence of urban and rural populations. 18. International statistical classification of diseases, injuries and causes of death, principles of its construction and significance. 19. Methodology for the study of morbidity according to the data of treatment in the treatment and prevention institutions. Types of morbidity, their comparative estimation. 20. General morbidity, sources of study, accounting documents, rules of filling. 21. Indicators of general morbidity, its features among the urban and rural population. 22. Infectious Disease: the expediency of special account, unit of observation, registration documents and their route, main indicators. 23. Incidence of major non-epidemic diseases: a list of nosological forms, expediency of special account, unit of observation, accounting documents and their route, main indicators. 24. Hospitalized morbidity: concept, expediency of special account, unit of observation, accounting document, methods of study, main indicators. 25. Incidence with temporary disability (TD): sources and methods of study, unit of observation, indicators of incidence of TIB 26. Medico-social significance of the most important diseases. 27. Diseases of the circulatory system their medical and social significance. Factors influencing the incidence of DCS. The system of medical and prophylactic institutions and measures to reduce this pathology. 28. Malignant neoplasms (MN), their medical and social significance. Leading risk factors of MN. The system of medical and preventive institutions and measures to reduce these diseases. 29. Tuberculosis, HIV / AIDS as a medical and social problem. 30. Comparative assessment of methods for studying morbidity in countries with different health systems. 31. Trends, age and sexual characteristics of certain types of morbidity in regions of the world, in countries with different economic development.

Content module 3. Organization of medical and preventive care for the population. 1. Organizational principles of medical and preventive care. 2. Types of medical and preventive care and institutions that provide it. 3. Types of medical and preventive care according to the degree of complexity. 4. Definition of the term "primary health care" (PHC). 5. Basic principles of PHC. 6. Factors of the development of family medicine. 7. The task of a family doctor according to WHO expert assessment. 8. Characteristics of existing organizational models of family doctors. 9. Examples of organization of the family practice system in different countries (Great Britain, 10. Scandinavian countries, USA, Russia). 11. The actual state of PMD in Ukraine, its phased reform on the basis of family medicine. 12. Possible organizational models of family medicine in Ukraine. 13. Departments of outpatient departments of family medicine. 14. Established posts of family medicine workers. 15. The tasks and content of the general practitioners work, cooperation with various health care institutions, and social services. 16.The role of outpatient clinics in providing medical care to the population. 17.Functions of outpatient institutions, their medical and preventive work. 18. The purpose and essence of the clinical examination method. Stages of clinical examination. 19. Changing the content and organization of the work of the outpatient institution provided by the development of family medicine. 20. Formation of the need for hospitalization. 21. Types of hospitals. Functions of the modern hospital, its constituent parts. 22. Measures on the rational use of the bed fund. The significance of continuity between community-based institutions and inpatient care. 23. The value of hospital replacement assistance, its organizational forms. 24. Functions and structure of the day care center. 25. Patient safety. 26. Accounting for the work of outpatient clinics and inpatient facilities, a methodology for determining and analyzing the indicators of their activities. 27. Features of medical provision of the rural population; factors influencing it. Staging of medical care. Institu- tions belonging to each stage. 28. Rural medicinal unit, its functions, structure. Tasks, prospects for further development. Amount of medical care at this stage. 29. Rural medical outpatient clinic as a PHC institution, structure, states, functions. 30. Central district hospital (CRC) as the center of specialized assistance to rural population. Task, structure, direction of improvement of activity. Organizational and methodical work of the Central Library. 31. Regional Hospital. Structure, volume and features of providing polyclinic and inpatient help to the population of the region. 32. Organization of the ambulance service (AS), its establishments. 33. Ambulance Station, main tasks and functions of the AS. 34. Outgoing Brigade of AS. Composition, tasks, functions. 35. Ambulance Hospital. Structure, states, tasks and main functions. 36. The organization of ambulance in the countryside. 37. Disaster medicine, the role of the ambulance service in the elimination of the consequences of supernatu- ral situations. 38. Assessment of the health of the elderly, its features. 39. Main tendencies in the organization of geriatric care in the world and in Ukraine. 40. Therapeutic and prophylactic institutions (units) and other institutions providing medical and social assistance to elderly people in Ukraine. 41. Prospects for the development of medical care for the elderly in the world and in Ukraine. 42. The notions of "health insurance" and "insurance medicine". 43. Features of the implementation of compulsory and voluntary medical insurance. 44. Problems of introduction of insurance medicine in Ukraine.