8. Epidemiological approach in social medicine: scope, essence and applications of epidemiology in medicine and health care

Epidemiological approach in Social medicine. Scope, essence and application of epidemiology in medicine and health care.

• Epidemiology derivates from Greek and means „study upon people“

Epidemiological approach

• in contemporary medical practice applications of epidemiology have been greatly extended
• In clinical medicine, epidemiology involves the study of groups of people rather than the direct study of individuals
• the investigation of the cause and natural history of disease, with the aim of disease prevention and health promotion
• The measurement of health care needs and the evaluation of clinical management, with the aim of improving the effectiveness and efficiency of health care provision

Scope

• There are important contrasts between the approaches to disease by clinicians and by epidemiologists
• The clinician asks the question: “What disease has my patient got?” The epidemiologist asks: “Why does the disease occur in winter rather than summer?”
• In order to answer such questions it is necessary to compare groups of people, looking for the factors that distinguish people with disease from those without
• For a clinician, the utility of a diagnosis is a pointer to management decisions. Therefore the diagnostic precision required is related to the specificity of treatments that are availab
• For an epidemiologist, diagnosis has different significance. It is a way of classifying individuals in order to make comparisons between groups

Essence

• Systematic collection and analysis of data about medical conditions in populations
• 3 main aims

1. to describe the distribution of the disease
2. to identify risk factors
3. to provide the data for the prevention, control and treatment of disease

Application

• the individual clinician only sees a selected and comparatively small proportion of sick people, and so many gain an erroneous impression of the relative frequency of different conditions in the community as a whole
• the most health care systems throughout the world, attempts are now being made to organize services according to priorities set by objective criteria rather than allowing them to be dictated solely by subjective judgements and traditional provision