The comprehensive cancer monitoring programme in Europe.
(65/367)
BACKGROUND: There continue to be major public health challenges arising from the increasing cancer burden in Europe. Drawing upon expertise from other European centres and networks, the Comprehensive Cancer Monitoring Programme in Europe project (CaMon) provides a central information resource of the cancer profile in European populations. METHODS: The cancer indicators fundamental to disease monitoring in Europe are illustrated in terms of definitions and availability. Where necessary data are supplemented by estimates, in order to make available cancer data to individuals and institutions in all Member and Applicant countries of the European Union (EU). The relevant methodologies are discussed. Finally, a major ongoing project examining time trends of cancer incidence and mortality in 38 European countries is described. RESULTS: In the European Union, there were approximately 1.6 million new cases of cancer according to the latest year available, and approximately, one million cancer deaths. About 2.6 million new cases of cancer, and 1.6 million deaths were estimated in Europe. Lung cancer is the most common cancer in Europe and together with cancers of the colon and rectum and female breast represent approximately 40% of new cases in Europe. CONCLUSION: The statistics generated by the project on cancer incidence, mortality, survival and prevalence, together with time trends and projections will be regularly updated and made available to a European Commission, and to a Community-wide audience via the CaMon website and via other means of dissemination, such as peer-reviewed journals. (+info)
Evaluation of Health Interview Surveys and Health Examination Surveys in the European Union.
(66/367)
BACKGROUND: The project 'Health surveys in the EU: HIS and HIS/HES evaluations and models' aims to assess the coverage of specific health and health-related areas in national and international surveys by reviewing and evaluating surveys, their methods and comparability, and by recommending appropriate survey designs and methods. METHODS: As basis for the evaluation, the project developed a health survey database. At present, Health Interview Surveys (HIS) and Health Examination Surveys (HES) from 18 Western European countries as well as from Canada, Australia and the USA are included. RESULTS: National HISs have been carried out regularly in almost all Western European countries. The HIS may consist of short health sections or modules within multi-purpose surveys or lengthy health interviews with several questionnaires. National HESs with a comprehensive focus have been conducted at regular or irregular intervals in five countries. The HES may comprise an interview and a few measurements or a comprehensive health examination. Sampling frames, fieldwork, quality control procedures and response rates vary greatly. Differences between measurement instruments used, in the wording of questions and in examination protocols reduce the comparability of many findings. CONCLUSION: The Internet based HIS/HES database allows for a quick reference and comparison of methods and instruments used in national health surveys. It illustrates the need for improving comparability. Collaboration and co-ordination is needed to promote comprehensive health monitoring supporting the development of national and European-level health policy. (+info)
The Hospital Data Project: comparing hospital activity within Europe.
(67/367)
BACKGROUND: The ability to measure and compare hospital activity between EU member states is important for policy, planning, financing and assessment of population health. Earlier initiatives in this area have been largely directed at standardising high-level indicator definitions without proper account of differences in health systems and health information systems. The Hospital Data Project (HDP) develops a methodology for improved comparability of hospital inpatient and day case activity data across Europe and produces a pilot common data set. All EU members, Iceland and the World Health Organisation are participants. METHODS: The approach comprises a detailed inventory of patient-level hospital data, identification of common areas, specification of data transformations and production of pilot data sets and metadata in a common format. An expert group developed a new diagnosis shortlist based on ICD-10. The project takes account of current work in the area of health care and morbidity indictors and applies the functional specification of health systems developed by the OECD. RESULTS: Seventeen countries have submitted data and metadata in the common format for a single year. Data on inpatients and day cases are classified by age, gender, diagnosis and type of admission. Numbers of hospital discharges, mean and median lengths of stay and population rates are reported. Test data on selected hospital procedures has also been collected. The full data set contains approximately 500,000 records, and software has been designed to facilitate validation and use. CONCLUSION: Results to date are promising. It is a first step in a complex area, and further work is required to extend and refine this approach. (+info)
Health monitoring in sentinel practice networks: the contribution of primary care.
(68/367)
BACKGROUND: The health monitoring programme of the European Commission has proposed a set of health indicators whereby the health status of member states can be measured. As part of that programme we considered how primary care might contribute relevant data. METHODS: Using a questionnaire distributed to personal contacts and health authorities, we investigated the activities of sentinel practice networks and sought opinions on the place of primary care as a provider of information on health indicators. Studies on the prevalence of diabetes mellitus and on the incidence of chickenpox were undertaken within selected networks. RESULTS: 33 networks were found who provided relevant information on a timely and continuing basis. Contributions varied; some were limited to monitoring influenza but others recorded morbidity data from every consultation. Recording methods ranged from the paper based to fully automated systems in which all morbidity was coded electronically at data entry. The study of diabetes mellitus showed less variation between national networks than currently suggested on the WHO database. For chickenpox we estimated the incidence of cases not presenting to general practitioners ranged between 3 and 27%. CONCLUSIONS: Information on health indicators needs to come from the place where relevant care is delivered; for many conditions that is from primary care. It can be delivered from appropriately resourced practices where the population is defined, the practice populations are nationally representative and data collection is automated. (+info)
European Emergency Data Project (EED Project): EMS data-based health surveillance system.
(69/367)
Emergency Medical Services (EMS) constitute a unique component of health care at the interface between primary and hospital care. EMS data within the pre-hospital setting represents an unparalleled source of epidemiological and health care information that have so far been neglected for public health monitoring. The European Emergency Data Project (EED Project) thus intends to identify common indicators for European EMS systems and to evaluate their suitability for integration into a comprehensive public health monitoring strategy. The article provides a brief overview on objectives and methodology in the form of a progress report. (+info)
Work-related health monitoring in Europe from a public health perspective.
(70/367)
BACKGROUND: In contrast to the enormous importance of work to the life of humans and societies, the working environment has so far played only a minor role in health monitoring. However, increasingly it is realized that work has a strong public health impact and therefore is also a cost factor to modern societies. The aim of the project WORKHEALTH, which is currently being carried out under the EU health monitoring programme, is the establishment of indicators for work-related health monitoring in Europe from a public health perspective. WORKING PROCEDURE: The work will be carried out by means of three work packages: a synopsis of existing work-related indicator sets together with the identification of areas still to be developed, resulting specification of new indicators for work-related health monitoring, and the development of operational definitions for these indicators. The project includes strong links to the fields of occupational health and safety, public health, social insurance and labour inspectorates to include demands from, as well as to disseminate results to, these different institutions also involved in aspects of work-related health monitoring. EXPECTED RESULTS AND CONTRIBUTIONS: Expected results will be indicators for work-related health monitoring that have been developed jointly with the participation of all Member States and different stakeholders within this field, and which permit comparable and reliable data at a national as well as European level. (+info)
EURO-MED-STAT: monitoring expenditure and utilization of medicinal products in the European Union countries: a public health approach.
(71/367)
BACKGROUND: There is uncertainty about the level of utilization and expenditure for medicines in the European Union (EU), making assessment of their impact on public health difficult. Our aim is to develop indicators to monitor price, expenditure and utilization of medicinal products in the EU, so as to facilitate comparisons. METHODS: There are four major tasks. Task 1: To catalogue data sources and available data in each EU Member State. Task 2: To assess the reliability and comparability of data among the EU Member States by ATC/DDD on country coverage, reimbursement, prescriptions, price category (e.g. wholesale, hospital, retail) and private versus public spending. Task 3: To develop Standard Operating Procedures for data management and to define clearly the proposed indicators in terms of objective, definition, description, rationale, and data collection. Task 4: To pool, compare and report the validated data according to the established indicators, using cardiovascular medicines as an example. RESULTS: Preliminary results from Tasks 1 and 2 are available and demonstrate the methodological difficulties in comparing data from different countries. Multiple data sources must be used. These cover different populations, and refer to different prices or costs. Nevertheless, useful data can be derived, illustrated by the example of lipid lowering medicines. The data shows that only five products are commonly available in all countries. Even when a medicine is available in all countries, there may be substantial differences in packages, which can hinder comparison. Data on utilization of statins shows high usage in Scandinavian countries and least in Italy. CONCLUSION: The preliminary results of EURO-MED-STAT show wide differences in availability, and use of medicines across Europe that may have substantial implications for public health. (+info)
The ECHI project: health indicators for the European Community.
(72/367)
BACKGROUND: Within the EU Health Monitoring Programme (HMP), the ECHI project has proposed a comprehensive list of 'European Community Health Indicators'. METHODS: In the design of the indicator set, a set of explicit criteria was applied. These included: i) be comprehensive and coherent, i.e. cover all domains of the public health field; ii) take account of earlier work, especially that by WHO-Europe, OECD and Eurostat; and iii) cover the priority areas that Member States and Community health policies currently pursue. Flexibility is an important characteristic of the present proposal. In ECHI, this has been emphasized by the definition of 'user-windows'. These are subsets from the overall indicator list, each of which should reflect a specific user's requirement or interest. RESULTS: The proposed indicators are, in most cases, defined as generic indicators, i.e. their actual operational definitions have not yet been attempted. This work has been, and is being carried out to a large part by other projects financed under the HMP, which cover specific areas of public health or areas of data collection. Apart from indicators covered by regularly available data, indicators (or issues) have been proposed for which data are currently difficult to collect but which from a policy point of view would be needed. CONCLUSION: All this points to the fact that establishing an indicator list which is actually used by Member States is a continuously developing process. This process is now continued by the first strand of the new EU Public Health Action Programme. (+info)