The concepts of disease and disease are very close in meaning, but the latter term has a broader interpretation. A disease is any deviation from the physiological norm. In turn, morbidity is a whole complex of indicators of the quality and structure of diseases, reflecting the level and frequency of the spread of pathologies. These indicators reflect the situation in the country as a whole, in a particular region, in a particular age or social group.
Incidence rates reflect the economic and social processes taking place within any country. If they rise, then we can conclude that there is a shortage of medical institutions or qualified specialists in the state. As a result, the mortality rate is of great importance, reflecting not only social problems, but also medical, biological and demographic ones.
At the same time, statistical data on morbidity allow us to analyze the effectiveness of medical institutions, both in general and separately in a particular region. It becomes possible to plan the scope of necessary preventive measures and determine the circle of persons who are subject to mandatory dispensary examination.
Classification of diseases
A unifieddiagnostics and registration of known nosological forms, which is conditionally divided into 21 classes and 5 groups. ICD (International Classification of Diseases) reflects the current stage of development of all medicine. Following the example of structuring the ICD, classifiers of diseases have been created in certain branches of medicine. The classifier is reviewed every 10 years in order to bring it into line with the data obtained during this period and achievements in medical science.
Types of morbidity on contact with medical institutions
Analysis of the incidence is carried out according to the following indicators:
- Actually, morbidity, cases of a certain pathology detected for the first time in the current year. Calculations are made by comparing newly emerged diseases to the average number of the population.
- Prevalence or soreness. Primary cases of detection of the disease in the current year and repeated cases are taken into account. Calculated by the ratio between all cases of detection of a certain class of disease, to the population for 1 calendar year.
- Pathological lesions, that is, disorders and diseases that were identified on medical examinations.
- True incidence. An indicator that includes information on the number of visits to a doctor, diseases detected during medical examinations, and data on causes of death.
Types of morbidity by population contingents
Information on contingents is classified by occupational, morbidity with temporarydisability, pregnant women and women in childbirth, other categories.
Occupational morbidity
This is the number of people who have received an occupational disease or poisoning in relation to the number of he althy workers. The main causes of occupational diseases include:
- the impact of harmful factors on humans;
- accidents;
- violation of the technological and production process;
- equipment failure;
- lack of sanitation facilities;
- non-use or lack of personal protective equipment at work.
Today, in our country, this figure is negligible. However, even isolated cases are socially significant, as they reflect the presence of unfavorable working conditions that require urgent preventive measures at work. For example, in relation to the 70s of the last century, occupational morbidity has decreased by 50%. Today, of all identified cases, 2/3 belong to chronic pathologies.
Disability morbidity
In this case, morbidity is the actual record of cases of illness in the working contingent. It does not matter if the disability was due to injury or other problems.
For this incidence analysis, the following indicators are taken into account:
- incapacity to work per a certain number of people per year;
- number of days of temporary lossworking capacity for 12 months;
- average duration of 1 case;
- morbidity structure, that is, the number of cases of treatment for one type of disease.
Morbidity in pregnant women and childbirth
It is regrettable to admit, but the statistics of the incidence of pregnant women is only getting worse every year, being the most urgent problem for all countries of the world. This indicator reflects not only the he alth of women, but also the offspring that will remain after her.
Some statistics (indicators in%, in relation to the number of women who have already given birth, data throughout the Russian Federation):
- the threat of termination of pregnancy decreased slightly in 2016 - an indicator of 18.2, in 2015 this figure was 19.0;
- venous complications in 2016 amounted to 5.5%, and in 2005 the rate was 3.9%;
- women with diabetes in 2016 - 3.14%, and in 2005 - 0.16%.
For individual diseases, it is already possible to clearly understand in which direction it is necessary to direct preventive measures in each medical institution of the country.
Morbidity in preschool and school children
As in the case of pregnant women and women in childbirth, the he alth situation of children and adolescents in the country is only getting worse. Thus, as of the beginning of this year, 32.8 cases of viral hepatitis were detected per 100,000 children aged 0 to 14 years, and intestinal infections in 1,625 children. Neoplasmswere diagnosed in 986 children in 2016 and only 953 in 2015.
Also, data can be analyzed by incidence among military personnel, specialists in various professions, and by other indicators.
Types of incidence by age
The incidence of the population is analyzed by age:
- newborns;
- children of school and preschool age;
- morbidity in adolescents;
- in the adult population;
- population over working age.
Child morbidity statistics aged 0 to 14 years (first-time diagnosis)
| Type of disease | number of cases per 100 thousand | |
| 2015 | 2016 | |
| Intestinal infections | 1380, 5 | 1425, 1 |
| Viral gnepatitis | 12, 0 | 17, 9 |
| Neoplasms | 477, 8 | 475, 6 |
| Anemia | 1295, 5 | 1279, 9 |
| Thyroid disease | 368, 8 | 358, 7 |
| Diabetes | 19, 2 | 21, 1 |
| Diabetes Insipidus | 0, 44 | 0, 59 |
| Obesity | 377, 5 | 367, 4 |
| Multiple Sclerosis | 0, 17 | 0, 21 |
| Total hits for the period | 177588, 1 | 179444, 1 |
Incidence statistics throughout the Russian Federation: children from 15 to 17 years old
| Type of disease | number of cases per 100 thousand | |
| 2015 | 2016 | |
| Intestinal infections | 528, 2 | 567, 8 |
| Viral hepatitis | 68, 6 | 60, 9 |
| Neoplasms | 1032, 4 | 1033, 9 |
| Anemia | 1676, 5 | 1717, 1 |
| Thyroid disease | 3783, 3 | 3736, 8 |
| Diabetes | 268, 7 | 294, 0 |
| Diabetes Insipidus | 6, 95 | 7, 05 |
| Obesity | 2935, 0 | 3033, 3 |
| Multiple Sclerosis | 7, 6 | 8, 8 |
| Total hits for the period | 224725, 9 | 225630, 6 |
Data for the entire Russian Federation, on the incidence of the population aged 55 years and over - women, men over 60:
| Type of disease | number of cases per 100 thousand | |
| 2015 | 2016 | |
| Intestinal infections | 127, 6 | 127, 2 |
| Viral hepatitis | 442, 0 | 462, |
| Neoplasms | 9197, 0 | 9723, 4 |
| Malignant neoplasms | 6201, 5 | 6725, 0 |
| Anemia | 732, 5 | 755, 6 |
| Thyroid disease | 3443, 6 | 3538, 3 |
| Diabetes | 8081, 2 | 8405, 0 |
| Diabetes Insipidus | 8, 91 | 9, 21 |
| Obesity | 1615, 8 | 1675, 7 |
| Multiple Sclerosis | 46, 8 | 50, 9 |
| Total hits for the period | 202462, 7 | 200371, 2 |
It should be noted that the incidence of cancer is steadily increasing in almost the entire population. Only in relation to 2015, last year this indicator slightly decreased in newborns and children under 14.
Do not forget that there is still a category of people who never go to the doctors. According to Profi Online Research, an independent research company, it was found that about 9% of respondents never go to medical institutions for help at all, but cope with all illnesses on their own.
Nevertheless, in terms of the overall incidence in the country, the numbers are not so scary. For some diseases, there is a slight, but still decrease in the number of patients.
| Type of disease | number of cases per 100 thousand | |
| 2015 | 2016 | |
| Intestinal infections | 418, 3 | 445, 2 |
| Viral hepatitis | 65, 4 | 64, 2 |
| Neoplasms | 1141, 8 | 1138, 3 |
| Anemia | 433, 9 | 433, 1 |
| Thyroid disease | 357, 7 | 355, 1 |
| Diabetes | 240, 6 | 231,6 |
| Diabetes Insipidus | 0, 60 | 0, 61 |
| Obesity | 350, 5 | 326, 1 |
| Multiple Sclerosis | 4, 6 | 4, 6 |
| Total hits for the period | 77815, 7 | 78602, 1 |
Classification by groups and nosological forms
Accounting for general morbidity is carried out according to two standard documents:
- Outpatient voucher, form No. 025-10/y, which is issued to each patient who comes to the clinic.
- Statistical card of the departed from the hospital. The card has a standardized form - No. 066 / y. The unit of observation is each case of hospitalization in any medical institution.
The first document allows you to register the patient and the reason for contacting the outpatient clinic, and the second in the hospital.
It is according to these documents that the classification into groups or nosological forms is carried out. The following classes are also distinguished.
Infectious incidence. Indicators of the incidence of an infectious direction allow you to respond as quickly as possible to outbreaks of the disease in a particular region. Registration of infectious patients is carried out regardless of the place of infection, the citizenship of the person who applied.
The incidence of infectious diseases in Russiadiseases, for the period from January to August 2016 and 2017, with indicators of increase or decrease:
| disease type | number of patients | cases per 100,000 | growth, decline | ||
| 2016 | 2017 | 2016 | 2017 | ||
| Typhoid fever | 10 | 20 | 0, 01 | 0, 01 | 2 times |
| Bacterial dysentery | 5083 | 3991 | 3, 48 | 2, 73 | - 21.7% |
| Acute hepatitis | 6010 | 8783 | 6, 0 | 4, 11 | 45, 8% |
| Measles | 78 | 240 | 0, 05 | 0, 16 | 3, 1 time |
| Rubella | 40 | 5 | 0, 00 | 0, 03 | - 8.0 times |
| Chickenpox | 605958 | 656550 | 448, 44 | 414, 78 | 8, 1% |
| Tick-borne viral encephalitis | 1787 | 1612 | 1, 22 | 1, 10 | - 10, 0% |
| Tick bites | 430332 | 462845 | 294, 57 | 316, 14 | 7, 3% |
| First syphilis detected | 19861 | 18406 | 13, 59 | 12, 57 | - 7.5% |
Incidence for socially significant and dangerous diseases:
- STDs;
- malignant neoplasms;
- trachoma;
- tuberculosis;
- mycosis and a number of other ailments.
In this case, the unit of study of non-epidemic incidence is each person who applied to the hospital where he was first diagnosed.
Statistical data on the incidence of the population by sex: first diagnosed "active TB" in 2016, compared with 2015:
| gender | number of patients | |
| 2015 | 2016 | |
| all forms of active TB | ||
| men | 57669 | 52929 |
| women | 26846 | 25192 |
| bothgender | 84515 | 78121 |
| respiratory tuberculosis | ||
| men | 56973 | 51647 |
| women | 25577 | 24071 |
| both sexes | 81850 | 75718 |
| extrapulmonary TB | ||
| men | 1396 | 1282 |
| women | 1269 | 1121 |
| both sexes | 2665 | 2403 |
| tuberculosis of the meninges and central nervous system | ||
| men | 131 | 158 |
| women | 83 | 84 |
| both sexes | 214 | 242 |
| tuberculosis of bones and joints | ||
| men | 637 | 555 |
| women | 345 | 333 |
| both sexes | 982 | 888 |
| Urogenital tuberculosis | ||
| men | 266 | 227 |
| women | 384 | 293 |
| both sexes | 650 | 520 |
| tuberculosis of peripheral lymph nodes | ||
| men | 223 | 199 |
| women | 260 | 234 |
| both sexes | 483 | 433 |
According to the nosological form, they are classified as a separate category of oncological diseases, the number of which is only increasing.
Incidence rate by stage of development of the tumor process and regions (as a percentage of the number of detected cases):
| Subject of the Russian Federation in % | Development stage | |||||||
| 1 | 2 | 3 | 4 | |||||
| 2015 | 2016 | 2015 | 2016 | 2015 | 2016 | 2015 | 2016 | |
| Total countrywide | 27, 5 | 28, 6 | 26, 2 | 26, 1 | 20, 1 | 19, 1 | 20, 4 | 20, 5 |
| Central Federal District | 28, 4 | 29, 5 | 25, 5 | 26, 3 | 20, 1 | 18, 5 | 21, 0 | 20, 8 |
| Northwestern Federal District | 26, 2 | 28, 5 | 25, 8 | 25, 0 | 21, 2 | 20, 3 | 19, 3 | 18, 8 |
| Southern Federal District | 27, 9 | 27, 1 | 26, 3 | 28, 3 | 18, 1 | 18, 1 | 20, 6 | 20, 0 |
| North Caucasian Federal District | 24, 4 | 24, 6 | 28, 1 | 28, 2 | 22, 6 | 21, 4 | 18, 6 | 19, 1 |
| Privolzhsky Federal District | 28, 7 | 28, 7 | 26, 4 | 25, 9 | 20, 1 | 19, 0 | 20, 0 | 20, 7 |
| Ural Federal District | 28, 4 | 29, 9 | 26, 1 | 24, 8 | 19, 5 | 18, 4 | 21, 2 | 21, 9 |
| Siberian Federal District | 26, 7 | 28, 1 | 25, 5 | 25, 5 | 20, 8 | 20, 1 | 20, 5 | 20, 1 |
| Far Eastern Federal District | 25, 5 | 27, 3 | 25, 6 | 24, 0 | 19, 2 | 18, 8 | 23, 5 | 24, 4 |
| Crimean Federal District | 19, 3 | 40, 7 | 18, 5 | 12, 5 | ||||
Statistics are also kept on the level of injuries, the number of mental illnesses and gender.
Methodology for studying and analyzing the incidence of the population
There are two main methods for studying morbidity:
- Solid. The technique is used to obtain operational data.
- Custom. The main goal is to identify the relationship between morbidity and environmental factors.
A striking example is the study of incidence in a particular region of the country or in a separate social group.
On the increase in the incidence of HIV infection, the Russian Federationis in 3rd place after Nigeria and the Republic of South Africa in 2016. At the same time, it cannot be said that all countries of the world can provide up-to-date data, for example, in Moldova and Ukraine, Tajikistan or Uzbekistan, there are not enough funds allocated for screening the entire population.
Comparing world data in 2016 compared to 2010, there is a downward trend in incidence in a number of countries:
| Region | % decrease or increase in incidence in 2016 compared to 2010 |
| East and South Africa | - 29% |
| West and Central Africa | - 9% |
| Middle East and North Africa | - 4% |
| Eastern Europe and Central Asia | + 60% |
| Asia and the Pacific | - 13% |
| Latin America and the Caribbean | - 5% |
| Western and central Europe, North America | - 9% |
If we talk about the Russian Federation, then the incidence structure is as follows:
| Subject of the Russian Federation in % | Number of patients diagnosed with HIV infection for the first time in their lives, in absolute units | |
| 2015 | 2016 | |
| Total countrywide | 100220 | 86855 |
| Central Federal District | 19445 | 11949 |
| Northwestern Federal District | 7268 | 5847 |
| Southern Federal District | 5322 | 6850 |
| North Caucasian Federal District | 1521 | 1716 |
| Privolzhsky Federal District | 21289 | 20665 |
| Ural Federal District | 16633 | 14367 |
| Siberian Federal District | 25396 | 23192 |
| Far Eastern Federal District | 2291 | 2269 |
| Crimean Federal District | 1055 | --- |
In general, morbidity is the most important indicator for determining the general he alth status of the entire population of a particular region and the whole country. Statistical data make it possible to timely direct preventive measures in the “right direction” and do everything to avoid an epidemic. It not only helps to establish the percentage of a particular type of disease among the population, but also to organize measuresto fight him.
The incidence rate is used along with birth and death rates to predict life expectancy and the likely percentage of the population that will retire on disability. For in-depth study and the ability to analyze the level and structure of morbidity at the state level, a mandatory registration of the incidence of patients has been introduced, which is carried out in hospitals and outpatient clinics.
