Epidemiology

Pcr-year rates commonly used to compare groups:

1. Birth rate: live births/1000 population

2. Fertility rate: live births/1000 population of females age 15-45 yr

3. Death rate: deaths/1000 population

4. Neonatal mortality rate: neonatal deaths (in the first 28 days)/1000 live births

5. Perinatal mortality rate: neonatal deaths + stillbirths per 1000 total births m The major cause is prematurity s The neonatal mortality rate is roughly 6/1000 (higher in blacks) ■ The fetal mortality rate is roughly 9/1000 (higher in nonwhites) a The perinatal mortality rate is roughly 15/1000

« A stillbirth (fetal death) is defined as a prenatal or natal death after 20 weeks' gestation

6. Infant mortality rate: deaths (from 0-1 year old)/1000 live births (the top three causes, in descending order, are congenital abnormalities, low birth weight, and sudden infant death syndrome)

7. Maternal mortality rate: maternal pregnancy-related deaths (deaths during pregnancy or in the first 42 days after delivery) /100,000 live births is The top three causes are pulmonary embolism, pregnancy-induced hypertension, and hemorrhage

« The rate increases with age and is higher in blacks Important points:

1. Medicare is health insurance for people who are eligible for Social Security (primarily people >65 years old as well as the permanently and totally disabled and patients with end-stage renal disease). Nursing home care is paid by Medicare only in the short term after a hospital admission; then it is paid by the patient (if the patient has no money, the state usually pays).

2. Medicaid covers the indigent and poor who are deemed eligible by the individual states.

Pregnancy And Childbirth

Pregnancy And Childbirth

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