population using health indicators. Health care is oriented towards the promotion and preservation of health; therefore, it is necessary to monitor and analyze the health of the population as a basis for setting priorities, planning and selection of appropriate measures and activities in the provision of health care. Reasons for the measurement of health status:
• Monitoring of health status of the population and taking action for improvement, analysis of the difference in time
• The study of changes in morbidity and timely response to lessening morbidity
• Analysis of the distribution of health resources and activities for their identification;
• Management of health projects and programs Health status indicators:
• Life expectancy
• Morbidity
• Standardized mortality rates;
• Incidence and prevalence of chronic mass diseases.
• Registers of vital events in the population (birth certificate, death certificate)
• Routine health statistics.
The health care system in the Republic of Serbia, organized and run it three institutions: the Ministry of Health of the Republic of Serbia, National Health Insurance Fund of Serbia and the Public Health Institute of Serbia "Dr Milan Jovanovic Batut". Public Health Institute of Serbia "Dr Milan Jovanovic - Batut" together with a network of institutes of Public Health in Serbia, collecting data about the health of citizens and the work of health institutions, analyzes the collected data on the health status and suggest measures for improving the health status of the citizens of Serbia , accompanied by the adoption and implementation of plans of health institutions in Serbia, monitor staffing situation in the health care and education of their movement, coordinated development and functioning health information system.
Keywords: indicators of health status
INTRODUCTION
The health status is the results of measuring the health of individuals or population with the help of health indicators. Health care is oriented towards improving and maintaining the health, it is therefore necessary to monitor and analyze the health of the population as a basis for prioritizing, planning and selection of the necessary measures and activities in the provision of health care.
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The health status of the population is not only a collection of assessment of health status of individuals, but the overall picture of the state of health and disease, and other problems related to population health in the community. Changes resulting transition trends in social, economic, and cultural environment affected the change of the concept of health and healthy living.
Development of methodology to measure health status PHASE I until the end of World War I
• It is characterized by the massive death from infectious diseases
• Register mortality
STAGE III until the end of the eighties
• It is characterized by AGING POPULATION
• Increased number of patients suffering from chronic not infectious diseases
• Increases the number of days of disability and disablement
• SCALE OF HEALTH STAGE IV
• Accelerated way of life , a number of factors
• Indicators of quality of life are registered
The definition of health in the spirit of the historic " absence of disease and decrepitude WHO
" is far behind us , completely psychophysical health is increasingly conditioned by their own individual concerns and factors within society. Health is increasingly represents a dynamic health, social and economic category , variable under the influence of various factors in the society. Health and health care are not solved exclusively within the health system and can not be viewed in isolation from the social, economic, political and cultural indicators that significantly affect the health of the population.
Reasons for the measurement of health status:
1. Monitoring health status of the population and taking actions for improvement, analysis of the difference in time;
2. Second study of changes in morbidity and timely response in reducing morbidity;
3. Analysis of the distribution of health resources and activities in their equalization;
4. Managing health programs and projects.
Most of the health care system today is characterized by an increase in the number of sectors that deal with health issues and complex relationships between them. The level of expectations of the health system and the needs of the population daily increases, there is less financial resources and rapid development of technology and education. It is evident that the aging population, the intensification of the "forgotten " and the presence of new diseases.
The basic function of public health is to assess the health status of the population and the health care organization with the goal of improving the health sector and the community.
Assessment of health status is based on monitoring and analysis of the determinants of health,
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leading causes of mortality and morbidity of the population. Results of research on the lifestyle and habits of the population are the basis for the organization of an efficient health care system oriented to health promotion and disease prevention.
The objectives of the assessment of the health status of the population are:
1. Registration of the most important health problems;
2. Evaluation and monitoring changes in health status;
3. Analysis of differences between individual groups of population and territories with the aim of reducing inequalities;
4. Implementation of measures to improve the health status of population;
5. Improving the model of financing and health management.
Indicators of health 1. Life expectancy;
2. Morbidity;
3. Infant mortality, perinatal mortality;
4. Standardized mortality rates;
5. The incidence and prevalence of chronic mass diseases.
6. The registers of vital events in the population (birth certificate, death certificate);
7. Routine health statistics.
In the City of Nis we have 19,1% older than 65. The mean age of the population was 43.1 years, the aging index is 141.2.
The birth rate is 8.6 ‰, the general fertility rate, 38.7 ‰, the mean age of mothers at elivery 29 years, born in marriage was 75.6% of children, the rate of nupciality was 4.2 ‰, the rate of divorceiality 1,3 ‰, divorce rate/ 1000 marriages 303 ‰ (one third), low birth weight 8.2% of newborns.
Overall mortality rate was 15.0 ‰, the natural increase was 6.3 ‰, life expectancy from 2010 to 2012. year. M = 72.5 and F = 77.3 years, the infant mortality rate was 8.6 ‰, the rate of early neonatal mortality rate was 3.7 ‰, the perinatal mortality rate of infants was 11.6 ‰, the rate of mortality was 8.0 ‰, the mortality rate of children under 5 years was 3.7 ‰.
In the structure of causes of death and cardiovascular disease continues to lead with 49.7%, with 21.7% of tumors, insufficiently defined conditions R00-R99 with 7%.
The health care system in the Republic of Serbia, organized and run it three institutions: the Ministry of Health of the Republic of Serbia, National Health Insurance Fund of Serbia and the Public Health Institute of Serbia "Dr Milan Jovanovic Batut".
The Ministry of Health is responsible for the overall organization and operating health system in and the preservation and improvement of public health, responsible for the operation of health insurance, regulated health policies, determines standards for work of ealth services, regulating quality control mechanisms and controls, organizes and monitors the work of the inspection services in the field of health care and total oversees and promotes the work of health institutions in Serbia.
Republic Health Insurance Fund of Serbia raises funds for health insurance that citizens pay from salaries and fund the provision of health care. Negotiate and finance the work of health institutions in Serbia purchasing plans of health facilities and controls the fulfillment of contractual obligations. Financing of health care institutions is based on the current situation and the available resources of the Fund. Absolutely funded health care provision in the health
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care plan from the network, except institutes for public health and health facilities that provide rehabilitation services.
Public Health Institute of Serbia "Dr Milan Jovanovic - Batut" together with a network of institutes of Public Health in Serbia, collecting data about the health of citizens and the work of health institutions, analyzes the collected data on the health status and suggest measures for improving the health status of the citizens of Serbia, accompanied by the adoption and implementation of plans of health institutions in Serbia, monitor staffing situation in the health care and education of their movement, coordinated development of health information system. Performs other healthcare services in the field of social medicine, hygiene, insurance fund users used services at the primary level only with health card. Insured Fund for health insurance usually included in the health care system right in the home health, and with the guidance of his chosen doctor moving towards health institutions of secondary and tertiary health care. Within the framework of activities of the Public Health Institute in Nis organized 12 community health centers.
Health care at the primary level include:
1) protection and promotion of health, prevention and early detection, treatment, rehabilitation of sick and injured;
2) preventive health care to the population groups exposed to increased risk of disease and other residents, in accordance with a special program of preventive health care;
3) health education and counseling for health improvement;
4) The prevention, early detection and control of malignant disease;
5) the prevention, detection and treatment of diseases of the mouth and teeth;
6) home care visits, treatment and rehabilitation at home;
7) Prevention and early detection of disease, health care and rehabilitation for persons placed in institutions for social welfare;
8) emergency medical care and ambulance transport;
9) pharmaceutical health care;
10) Rehabilitation of children and youth with disabilities in physical and mental development;
11) mental health;
12) palliative care;
At the secondary level in the Republic of Serbia, it is organized the 77 hospitals, 40 general and 37 special. Patients are referred to the hospital when their health problems beyond the competence of medical doctors of primary health care home health conditions or need an expert opinion of a higher level of health care. At this level of health care is organized in the area Nisava and Toplica administrative district of five general hospitals and three specialty hospitals.
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Health care at the secondary level involves specialized consulting business. In relation to health activity at the primary level include more complex measures and procedures for the detection of diseases and injuries as well as treatment and rehabilitation of sick and injured with the use of appropriate equipment and personnel as prescribed by the Ministry of Health.
Hospital health activities include the diagnosis, treatment and rehabilitation, health care and accommodation in hospitals, and pharmaceutical services in a hospital pharmacy.
When exhausted all treatment options in general or special hospital patient is referred to the highest level of care at the tertiary level. Refers to the clinical centers in our country which has 4 (Belgrade, Nis, Novi Sad and Kragujevac) or one of the clinics (6) or institute (16) and KBC (4). At this level of care patient arrives with instructions chosen physician, based on the advice of medical doctors in general and special hospitals.
Health care at the tertiary level includes the provision of the most complex forms of health care and specialist-consultative and hospital health activities with the use of sophisticated equipment and more specialized medical doctors. This level of care is organized in places where there is a college of health professions. So that in these institutions carry out scientific research and educational activities. In the area of activity of the Public Health Institute in Niš has two tertiary health institutions.
For more levels of health care in the Nisava and Toplica administrative district organized by the Public Health Institute, Department of Forensic Medicine and the Institute for Blood Transfusion
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