Cc ch s sc kho

cng ng v QUN l
thng tin y t

Mc tiu hc tp
Trnh by c cc ch s nh gi sc kho cng ng
v cc phng php nghin cu t l mc bnh, u, nhc

im ca tng phng php.

Trnh by cc nhm thng tin y t c bn, nu c

ngha ca tng ch s trong cc nhm thng tin.

Trnh by c cc phng php thu thp thng tin.

Nu c cch tnh ton, phn tch, trnh by, ph bin,
thng bo v s dng cc thng tin y t

Cc nhm thng tin y t

Cc ch s v sc kho: T l mc bnh, t l t vong,

pht trin th lc, tui th trung bnh

Cc thng tin v cng ng: Tnh hnh dn s, kinh t,

vn ho, x hi

Cc thng tin v chm sc v phc v sc kho C.

Cc thng tin v cc yu t nguy c cho sc kho C.

Cc ch s sc kho

1. T l mc bnh
2. T l t vong

3. Tnh hnh pht trin th

lc
4. Tui th trung bnh

Cc khi nim v t l mc
bnh
1. T l mi mc
S trng hp mi mc mt bnh c th c
thng bo trong mt khong thi gian trn dn
s trung bnh trong cng khong thi gian .

Cc khi nim v t l mc
bnh
2. T l hin mc

2.1.T l hin mc thi im: S trng hp

ang mc mt bnh c th (c mi v c)
ti mt thi im trn dn s ti thi im
.
2.2.T l hin mc giai on: S trng hp
ang mc (c mi v c) mt bnh c th
c xc nh trong mt khong thi gian trn
dn s trung bnh trong cng thi gian .

Cc khi nim v t l mc

bnh
3. T l tn thng bnh l:
L tt c cc trng hp mc bnh v tn thng c xc nh do khm sc kho trn dn
s ca cng ng c khm sc kho.

Tnh trng mc bnh v t vong do lao ti mt cng

1_____________________________________
ng 200 ngi c nguy c cao c biu din qua s
___+2________________+________________
sau:

________3_____________________________
___________+4_______________________+_
________________5_____________________
____________+_______6_________________
______________+_________7_____________
____________________________8_________
_______+________________________9_____
____________________________________10
______________________________________
_+____________________________________
______
1/1/00
30/6/00
1/1/01

T l mi mc lao nm 2000:
= 4/ [200+(2005):2]x1000=4/197,5x1000=20,3%o
T l hin mc lao ngy 30/6/00:
= 7/(200-2)x1000=7/198x1000=35,4%o
T l hin mc lao nm 2000:

Cch nhn bit v bnh tt

M hnh tng bng
Bnh pht hin c
Bnh tht s
Bnh cha pht hin c

Cc phng php nghin cu

t l mc bnh
1. Nghin cu s khm, cha bnh:
S khm cha bnh c phn

tch hng thng, hng qu, hng nm

xc nh tn sut v c cu bnh tt
ca nhn dn khi h n cc c s y t
khm, cha bnh

Nhng yu t nh hng n phng php

phn tch s khm cha bnh ti y t c s.
+ T pha ngi dn:
- Nhn thc cha y v bnh tt.
- Ngho.
- Xa trm y t.
+ T pha cn b y t:
- Trnh chuyn mn km.
- Tinh thn thi phc v cha tt.
- C s vt cht trang thit b, nh ca, thuc men
thiu.
- Thiu tinh thn trch nhim trong cng tc thng k
bo co (cha coi cng tc ny l vic cn thit, quan
trng cn phi lm).
+ T pha cng ng:
- C nhiu hnh thc khm cha bnh.
- Qun l h thng thng k bo co cha tt.

* Bin php khc phc

- Tng cng tuyn truyn v khm cha bnh,
pht hin bnh sm v iu tr kp thi cc
bnh thng gp ti cng ng.
- Nng cao trnh chuyn mn, tinh thn thi
phc v cho cn b y t.
- Lm cho cn b y t c s nhn thc c tm
quan trng ca cc ch s v tnh trng
bnh tt, thy c trch nhim ca trnh
mnh trong cng tc thng k.
- Tng cng qun l cc c s y t trn a bn.

Cc phng php nghin cu

t l mc bnh
2. Nghin cu t l mc bnh qua khm
sc kho:
Tin hnh khm sc kho cho mt nhm

i tng hoc ton th cng ng

Tnh hnh bnh tt ca hc sinh tiu hc v

trung hc c s thuc 3 x Minh Lng, Phc
Thnh, V Hi huyn V Th thng 10/1999 qua
khm pht hin
Bnh
1.
2.
3.
4.
5.

6.
7.
8.

Ngoi da
H hp
Tim mch
Tiu ho
Tit niu
Tai mi hng
Rng hm mt
Bu c

T l mc () trn/1000 h/s
32
47
06
58
10

327
899
97

3. Nghin cu s liu v nguyn nhn

cht:

Thng k nguyn nhn cht cho chng ta nim

chnh xc v t l mc bnh v nhng tn thng
khng hi phc. C cu v nguyn nhn cht gip
chng ta a ra nhng bin php hu hiu h
thp t l cht v ko di cuc sng.

Tuy nhin cc nguyn nhn cht khng phn nh trc

tip phn ln cc bnh khng lm cht ngi m

nhng bnh ny ch lm gim tnh hnh sc kho,
lm mt tm thi hoc vnh vin kh nng lao

Mi nguyn nhn cht cao ti cc bnh vin

Vit Nam t 1993 - 1996 tnh trn 100.000 dn
1.
2.
3.
4.

5.
6.
7.
8.
9.
10.

Vim phi
Lao
Xut huyt no
Cao huyt p
Tai nn giao thng
T t
Bnh c quan tiu ho
Ng c ho cht
Bnh l chu sinh
S xut huyt

1,1
1,0
9,9
0,8
0,7
0,6
0,4

0,4
0,4
0,4

Cc phng php nghin cu

t l mc bnh
4. Phng vn cc gia nh bng b cu hi
chun b sn v tnh hnh bnh tt v chm
sc sc kho ca h trong mt khong thi gian:
2 tun, 1 thng...
5. Xc nh tnh hnh bnh tt bng phiu theo
di tng trng hp m au ti h gia nh trong
mt khong thi gian nht nh.

Mt s ch s v t l mc bnh thng
s dng

1. T l mc bnh chung
T/s cc trng hp mc mi trong nm
TLMBC

------------------------------------------------

1000

Dn s trung bnh trong nm

Mt s ch s v t l mc bnh thng
s dng

2.T l au m
T l au m th hin nhu cu ng thi cng l
yu cu ca ngi dn trong khm cha bnh. T l
au m xc nh mc hin mc trong 1 nm ti
mt a phng.
T/s cc tr.hp mc (c mi v c) trong nm

TLau m = ----------------------------------------------------- x
1000
Dn s trung bnh trong nm

Mt s ch s v t l mc bnh thng
s dng
3. S ln khm bnh trung bnh ca nhn dn
trong khu vc:
Tng s ln khm c thc hin trong nm

SLKBTB = -------------------------------------------------------Dn s trung bnh

Ch : Cn phn bit

- S ln khm ti trm y t
- S ln khm pht hin
- S ln khm c thc hin bi cc c s y t khc

- S ln khm bnh ti nh

Mt s ch s v t l mc bnh thng
s dng
Cc bnh truyn nhim
1. T

13. Bch hu

2.Thng hn v ph thng hn

14. Ho g

3. L trc trng
4. L amp

5. Hi chng l

15. Un vn s sinh
16. Un vn khc

17. Si

6. Tiu chy

18. Nghi bi lit

7. Vim no virus

19. Quai b

8. St Dengue

20. Cm

9. Vim no virus

21. Adenovirus

10. S ngi tim phng di

22. Dch hch

11. Vim mng no do m cu

23. Bnh than

12. Thu u

24. Leptospira

Mt s ch s v t l mc bnh thng
s dng

4. T l mc bnh truyn nhim

S tr.hp mc bnh truyn

nhim
TLMBTN = --------------------------------------x1000
Dn s trung bnh

Mt s ch s v t l mc bnh thng
s dng

5. T l mc bnh x hi

Bnh lao, bnh phong, bu c, tm thn, mt

ht, st rt, hoa liu (STD).

Cc bnh c gi l bnh x hi l cc bnh thng

din bin mn tnh c t l mc rt cao v t l
mc bnh ph thuc c bn vo iu kin x hi.
S trng hp mc bnh x hi
TLMBXH = -------------------------------------- x 1000
Dn s trung bnh

Mt s ch s v t l mc bnh thng
s dng

6. T l tn thng bnh l
Tt c cc trng thi bnh l
TLTTBL = ----------------------------------- x 1000
Tng s ngi c khm

Mt s ch s v t l mc bnh thng
s dng

7. T l mc bnh phi ngh vic

+ S trng hp ngh m trn 100 cn b cng nhn
vin:
+ S ngy ngh m trn 100 cn b cng nhn vin
+ Thi gian trung bnh ca mt trng hp ngh m
+ C cu bnh tt (nguyn nhn) ngh m

Mt s ch s v t l mc bnh thng
s dng

8. T l mc bnh phi nm vin:

S trng hp phi iu tr ni tr
= --------------------------------------------------------x 1000

Dn s trung bnh ti a phng

T l mc bnh phi nm vin thng c

dng lp k hoch v qu ging bnh.

Mt s ch s v t l mc bnh thng
s dng

9. T l bnh nhn chuyn

tuyn
S trng hp chuyn tuyn
T l bnh nhn = --------------------------------------------------- x 100
chuyn tuyn
Tng s trng hp n
khm

Mt s ch s v t l mc bnh thng
s dng

10. C cu bnh tt:

S trng hp mc (mi mc/hin mc)
ca mt bnh hay mt nhm bnh
------------------------------------------------------------- x 100
Tng s trng hp (mi mc/hin mc)
ca mt bnh hay mt nhm bnh
nghin cu su hn cn phn chia cc
ch c trn theo gii, tui, ngh nghip, theo
c tnh ca tng nhm dn c.

 ngha ca vic nghin cu

t l mc bnh:
- nh gi s bin ng trong sc kho ca nhn dn
(mc mc v c cu tng bnh).
- nh gi nhu cu ca cng ng trong chm sc v
BVSK.
- Xc nh mi lin quan ca cc iu kin kinh t vn
ho x hi v cc yu t nguy c vi sc kho cng
ng.
- nh gi hiu qu ca cc bin php phng v cha
bnh.
- Xc nh vn y t u tin ti cng ng.

Thng k tnh trng t vong

1. T l cht th (chung)

Tng s cc trng hp cht

C.M.R = --------------------------------------------------- x 10n
Dn s trung bnh trong 1 giai on

Thng k tnh trng t vong

2. T l t vong theo nguyn nhn
S t vong do 1 nguyn nhn
= ------------------------------------------------x 10n
Dn s trung bnh trong 1 giai
on

Thng k tnh trng t vong

STT

1
2
3
4
5
6
7
8
9
10

Loi bnh

Vim phi
Lao
Xut huyt no
Cao huyt p
Tai nn giao thng
T t
Bnh c quan tiu ho
Ng c ho cht
Bnh l chu sinh
St xut huyt

T l %

1,1
1,0
0,1
0,8
0,7
0,6
0,4
0,4
0,4
0,4

Thng k tnh trng t vong

3. C cu t vong theo nguyn nhn
Xc nh c cu t vong cho chng ta hnh
nh r nt v th t cc nguyn nhn gy t
vong, gip chng ta thy c mc nguy
him ca cc bnh.

S t vong do 1 nguyn nhn xc

nh
CCTVTNN = ------------------------------------------------------x 100
Tng s t vong do mi nguyn
nhn

Thng k tnh trng t vong

1.2.4. T l t vong ca mt bnh
L ch s cho php chng ta thy c r nt
hn mc nguy him ca mt bnh no
.
V d: Bnh ung th c t l t vong rt cao.
Bnh si c t l t vong thp.
S trng hp t vong do 1 bnh
TLTVDMB = ------------------------------------------------- x 100
Tng s ngi mc bnh

1.2.5. Cc t l cht tr em v b
m
1.2.5.1. T l cht s sinh
S tr sng, cht trong 28 ngy sau
TLCSS = ---------------------------------------------------- x
10n
Tng s tr ra sng
1.2.5.2. T l cht sau s sinh
S tr cht t 28 ngy n 12 thng
tui
TLCSSS = ---------------------------------------------------------- x 10n

1.2.5. Cc t l cht tr em v b m
1.2.5.3. T l cht tr em di 1 tui
S tr cht di 1 nm tui
TLCTE<1T = -----------------------------------------------x 10n
Tng s tr ra sng
1.2.5.4. T l cht chu sinh
S tr ra cht + S tr cht < 7 ngy
TLCCS = --------------------------------------------------------- x 10n
Tng s tr ra sng

1.2.5. Cc t l cht tr em v b m
1.2.5.5. T l cht tr em t 1 - 5 tui (t 1 n
cn 5)
S tr cht t 1 - 5 tui
TLCTE 1-5 tui = ---------------------------------------------- x 10n
S tr trung binh t 1-5 tui
1.2.5.6. T l cht b m
S b m cht do nguyn nhn cha

TLCBM = ----------------------------------------------------------- x 10n

1.2.6. Nhng nm sng tim tng b

mt

* Cc

ch s:
+ S nm sng tim tng b mt = s tui (nm)
b mt x s t vong.

+ T l mt kh nng sng tim tng cho 1 qun

th:
Tng s nm sng b mt
= ------------------------------------------- x 10n
Qun th < 66 tui

1.3. Thng k tnh trng th lc ca cng

ng
1.3.1. Cc yu t nh hng n pht trin th
lc:
- Ni ging

- Gii, tui
- Vng sinh thi
- Tinh trng mc bnh

- Dinh dng
- Rn luyn thn th
- iu kin sng

1.3. Thng k tnh trng th lc ca cng

ng
1.3.2. Cc ch s nh gi th lc
1.3.2.1. Cc ch s nhn trc hc
Chiu cao, cn nng, vng ngc, vng u, vai,
vng cnh tay, cng tay, cng chn, i.

1.3.2.2. Cc ch s sinh l
- Dung tch sng ca phi
- Lc ko ca c
- Huyt p, lng protein trong mu...

1.3.2.3. Cc du hiu hnh th

Th trng, s pht trin h c, hnh dng lng ngc,
chn, kiu hnh bn chn, cc du hiu pht trin
sinh dc...

1.4. Tui th trung bnh (TB) ca dn

c:

Tui th TB ca dn c l s nm trung bnh m

mt th h hay nhng ngi cng la tui sng c trong nhng iu kin kinh t vn ho x hi v
t l cht khng thay i.

Tui th TB ca dn c l mt ch s tng qut

nh gi tnh trng sc kho, bnh tt ca cng

ng c tnh n cc iu kin kinh t, vn ho,

x hi v c bit ch s ny chu nh hng rt
ln ca t l cht.

Gi tr ch s pht trin
con ngi

Tui th bnh
qun trung
bnh (nm)

1987:62,0
1991:62,7
1992: 63,4
1993:65,5
1994:66,0
1995:66,4
1997:67,4
1998:67,8
1999:67,8
2000:68,2
2001:68,6
2002:69,0
2003:70,5
2004:70,8
2005:73,7

0,608
0,498
0,464
0,472
0,514
0,539
0,540
0,557
0,560
0,644
0,671
0,682
0,688
0,688
0,691
0,704
0,709
0,733

2. Qun l thng tin y t:

2.1. Qun l thng tin y t l g?
L qu trnh thu thp, x l, phn tch, trnh
by, thng bo, s dng v lu tr nhng thng tin
v sc kho ca cng ng.

2. Qun l thng tin y t:

2.2. Cc nhm thng tin y t:

Tnh hnh dn s, kinh t, VH-XH ca cng

ng

Tnh hnh sc kho v bnh tt ca cng ng

Tnh hnh chm sc v phc v sc kho cng

ng

2. Qun l thng tin y t:

2.3. Cc phng php thu thp thng tin y t:
2.3.1. S dng cc ti liu v thng tin sn c
2.3.2. iu tra:

- Quan st
- Khm sc kho
- Phng vn
- Tho lun nhm

2. Qun l thng tin y t:

2.4. X l v phn tch thng tin
2.5. Trnh by thng tin y t
2.6. Thng bo v lu tr thng tin y t
2.7. S dng thng tin y t trong vic lp k hoch

CSBVSK cng ng

Bi tp 1:

Dn s trung bnh x A nm 2000 l 5000 ngi.

S ph n 15-49 tui l :
1200
S tr em t 0-5 tui l:
400
S tr ra sng:
90
S lt ngi n khm v iu tr ti trm 2000
S bnh nhn chuyn tuyn
36
S ngi mc st rt cui nm 1999 l 25, cui nm 2000
l 30
S ngi cht trong nm 2000 l 30, trong , cht do suy
kit tui gi 18, tai bin mch mu no 4, ung th 2, tai
nn 1, st rt 2, cn li l cc nguyn nhn khc.
Thng 10 nm 2000 trm y t tin hng khm ph khoa
cho ph n 15- 49 tui, pht hin 360 ngi mc bnh
ph khoa.
Hy lit k v tnh cc ch s lin quan n tnh trng
bnh tt v t vong ti x A nm 2000

Bi tp 2:

Tnh trng t vong do HIV/AIDS ti M nm 1987

c trnh by theo cc s liu sau
Nhm
tui

Dn s
(x1000)

S t
vong

S ph n
da en
(x1000)

S t
vong

0-4
5-14
15-24
25-34
35-44
45-54
> 55

18.252
34.146
38.252
43.315
34.305
23.276
51.855

191
47
492
5.026
4.794
1.838
1.077
3

1.393
2.697
2.740
2.549
1.663
1.117
1.495

47
7
145
1.326
1.212
395
168
1

243.401

13.468

14.104

3.301

Khng r

Tng

Tng s t vong ti M nm 1987 l 2.123.323

Hy tnh:

T l cht th

T l t vong c trng theo nguyn nhn

T l t vong lin quan n HIV/AIDS trn

nhng ngi t 35-44

T l t vong lin quan n HIV/AIDS ph

n da en t 35-44

T l cht th=Tng s t vong/Dn s x100000=

2.123.323/243.401.000x100.000=872,4

T l t vong c trng theo nguyn nhn=

(t l t vong do HIV/AIDS ti M nm 1987)=

T l t vong lin quan n HIV/AIDS trn nhng ngi t 35-44

T l t vong lin quan n HIV/AIDS ph n da

en t 35-44

Bi tp 3:

Trong nm 1987 tng ss t vong lin quan

n HIV/AIDS N l 12.088 v Nam l
1.380. Dn s c lng nm 1987 i vi N
v Nam l: 118.531.000 v 124.869.000.
Hy tnh:

T l t vong do HIV/AIDS theo gii

Nhng loi t l t vong no c th tnh c

t bi tp 2 v 3

Nhn xt mc t vong do HIV/AIDS gia

Nam v N

Bi tp 4:
Ti x M, nm 1999:

Dn s trung bnh l 5.800

S trng hp mc lao mi l 4

S trng hp tn ng nm 1998 l 5.

1 trng hp t vong do lao

Hy tnh cc t l mc v t vong do lao nm 1999 ti

x M

Mt s t l mc bnh ti Vit Nam :

Bnh Lao:
-

Lao phi BK+: 70/100.000

Lao mi th: 106/100.000
c tnh mi nm c 130.000 trng hp mc mi mi th

Bnh tm thn:
- Cc loi: 10% dn s
- Phn lit 1% dn s
St xut huyt :
- Trung bnh hng nm 100/100.000
- Khi c dch 260-640/100.000
Vim no Nht Bn:
- Mc 1-20/100.000
- T l t vong do bnh 40%
Vim gan B: T l nhim (huyt thanh dng tnh) 12-26%
Thng hn:
5% dn s
Trn th gii:
Ung th: (1985)
7,6 triu ca
HIV/AIDS:
20 triu (18,5 ngi ln v 1,5 tr em)
Chn thng: Hng nm 4,2 triu ca t vong, 78 triu ngi tn

ICD- International Clacification of Dises 10 Diseases

(1994)
1.
2.

3.

4.
5.
6.
7.
8.

9.
10.
11.

Bnh nhim trng v k sinh trng

Bu tn sinh
Bnh ca mu, c quan to mu v cc ri lon lin
quan n c ch min dch
Bnh ni tit, dinh dng v chuyn ho
Ri lon tm thn , hnh vi
Bnh h thn kinh
Bnh mt v phn ph
Bnh tai v xng chm
Bnh h tun hon
Bnh h h hp
Bnh h tiu ho

ICD- International Clacification of Dises 10 Diseases

(1994)
12. Cc bnh da v m di da
13. Bnh h c, xng khp v m lin kt
14. Bnh h sinh dc tit niu
15. Thai nghn, sinh v hu sn
16. Mt s bnh l xut pht trong thi k chu sinh
17. D tt bm sinh, bin dng v bt thng v nhim
sc th
18. Cc triu chng, du hiu v nhng biu hin lm
sng v cn lm sng bt thng, khng phn loi
phn khc
19. Chn thng, ng c v mt s hu qu khc do
nguyn nhn bn ngoi
20. Nguyn nhn ngoi sinh ca bnh tt v t vong
21. Cc yu t nh hng n tnh trng sc kho v
tip xc dch v y t

Test 1
Ch s khng trc tip nh gi sc kho cng ng
l:

A. T l mc bnh

B. T l t vong
C. Tnh trng pht trin th
lc
D. Tui th trung bnh
E. Tnh trng kinh t VH-

XH

Test 2
Nhm ch s quan trng nht nh gi tinh trng sc
kho ca cng ng l:

A.T l mc bnh
B. T l t vong
C. Tnh trng pht trin th
lc

D. Tui th trung binh

E. Tnh trng kinh t VH-XH.

Test 3
Ngi ta ghi nhn 10 trng hp mc lao trong nm ti
mt a phng, c th tnh c:

A. T l mi mc
B. T l hin mc thi
im
C. T l hin mc giai

on
D. T l tn thng bnh