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DEVELOPMENTS ON THE DISSEMINATION OF THE EUROPEAN COMUNITY HEALTH INDICATORS

DEVELOPMENTS ON THE DISSEMINATION OF THE EUROPEAN COMUNITY HEALTH INDICATORS. Luxembourg, 1st June 2007 Antoni Montserrat European Commission DG SANCO Health Information Unit. Key Line An EU health information system, with indicators on health-related behaviour, diseases and health systems

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DEVELOPMENTS ON THE DISSEMINATION OF THE EUROPEAN COMUNITY HEALTH INDICATORS

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  1. DEVELOPMENTS ON THE DISSEMINATION OF THE EUROPEAN COMUNITY HEALTH INDICATORS Luxembourg, 1st June 2007 Antoni Montserrat European Commission DG SANCO Health Information Unit

  2. Key Line • An EU health information system, with indicators on health-related behaviour, diseases and health systems • Being developed on the basis of Public Health Programme projects and other EU actions • In cooperation with Eurostat, OECD and WHO • Based on common instruments and mechanisms • for health reporting (surveys, registers, hospital information, etc.) • Available through the DG SANCO web site and the internet-based EU Health Portal, as well as through regular EU health reports

  3. Current legal basis for the developments of Health indicators in the EU Public Health Policy • The Work Plans 2005, 2006 and 2007 contains explicit mention to health indicators: • Development and implementation of indicators and collection of data on socio-economic determinants of health, inequalities in health, gender health, health of specific population groups (including feasibility and costing). • Breakdown of the Healthy Life Years Indicator by socioeconomic categories using the standard EU methodology. • Development of indicators and collection of data on public health, prevention and health promotion policies in the Member States, and indicators for EU policy and legislation with a health impact (including feasibility and costing); • Promotion of health indicators systems and reporting in the Member States using the European Community health indicators list and the Healthy Life Years Indicator, focusing in particular on integrating their use in the Member States joining the EU after 1 May 2004 and candidate countries.

  4. Future legal basis for the developments of Health indicators in the EU Public Health Policy • For the period 2007/2013 a new Health and Consumer Protection Programme should replace the existing Public Health Programme (if approved by the Council and the Parliament). • New strand ‘Generation of knowledge’. • Regulation from the Council and the Parliament (developed by Eurostat) creating a statistical framework for data collection on health and safety at work in some areas (health status, causes of death, health care). It should be a ‘umbrella regulation’ to be developed via Commission Regulations. • Via Commission Decision a Direct contract agreement with WHO and OECD for developments in several areas e.g. Indicators on Health Quality, Data collection on Primary Care, etc.

  5. Future legal basis for the developments of Health indicators in the EU Public Health Policy • The new Research Programme (FP7) introduces a new common approach between research activities and health information under the pillar ‘Cooperation’ • Emphasis will be put on translational research (translation of basic discoveries into clinical applications), the development and validation of new therapies, methods for health promotion and disease prevention, diagnostic tools and technologies, as well as sustainable and efficient health care systems. • Some examples in ‘Translating research for human health’: • Health Examination Survey: to develop a pilot health examination survey at EU level including biomonitoring approaches to provide data for European Community Health Indicators and based on existing feasibility studies. • Brain diseases and ageing: to better understand the health impact of injury reduction strategies directed at elderly persons with economic cost/benefit analysis. • Studies on how health professionals implement best clinical practice (eg. Continuing medical education, role of professional organisations, registries of interventions and follow-up of patients) • Creation of a representative sentinel network in each Member State to monitor patient safety incidents • Mapping of clinical and out-patient care for psychiatric illnesses, and patient rights structures, including compulsory admission and treatment of the mentally ill in the criminal justice system.

  6. Future legal basis for the developments of Health indicators in the EU Public Health Policy • DG SANCO will elaborate during 2007/2008 a proposal for a • Commission Communication on the European Health Information, Knowledge and eHealth System: • Summarising the principles basing the EU health information and knowledge system, • The responsibilities of the different actors in this field, the role of DG SANCO, • The national and EU responsibilities on the mechanisms for collecting data (health surveys, hospital information, etc.), • The interoperability of different systems of health indicators, the cooperation with other actors (Eurostat, ECDC, OCDE), • The role of the consultative structures • A code of good practices on health information • Defining the content of the Electronic Health Card and the type of information to be shared by Member States • Obligations that the European Commission should assume respect to the Member States in the field of health information. • The proposal should be discussed in all the existing SANCO advisory structures

  7. Future legal basis for the developments of Health indicators in the EU Public Health Policy • In 2007 the Commission plans to adopt a new Health Strategy. This will be an ambitious project and one of DG SANCO's top priorities for the coming year. It aims to: • Set a clear strategic framework which covers the broad range of work done within DG SANCO, as well as in other parts of the Commission, and includes some new initiatives • Set broad objectives for a 10 year timeframe, with a 5 year mid-term review • Enable the closest possible cooperation with Member States to improve health in Europe in the decade to come • Focus on key health issues, on mainstreaming health in all policies, and on global health issues address key challenges such as pandemics and other threats, demographic change, new technologies, health inequalities, chronic disease burden, globalisation, patient and health professional mobility ….(etc) • How to input into the Strategy now: • A further discussion document including questions will be put on the SANCO website within Strategy White Paper will be developed • Adoption of the Strategy is expected mid-late 2007 • Council will then discuss the Strategy • Stakeholders and experts are encouraged to take the opportunity to input into the development of the Strategy.

  8. Future legal basis for the developments of Health indicators in the EU Public Health Policy • Legislative initiatives 2007-2008 • A Consultation regarding Community action on health services it’s in place • Before the Commission brings forward proposals for Community action on health services, we are consulting all stakeholders involved in the health services sector, on the basis of a specific consultation document. • Specific reference to mobility of patients indicators.

  9. Future legal basis for the developments of Health indicators in the EU Public Health Policy • Non legislative initiatives 2007-2008 • Commission Communication on EU action on rare diseases and, eventually, a Recommendation from the Council will be prepared. Epidemiological indicators needed. • Commission Communication and Council Recommendation on health consequences of climate change will be prepared. Indicators related to monitoring communicable diseases, overmortality during heat waves or cold spells, impact of UVR, airborne allergens and others needed. • Commission Communication on cancer. Focusing on screening. Still in development. • In coming years (2008-2013) • European Health Examination Survey, • Autistic Spectrum Disorders • Neurodegenerative, neurodevelopment and non-psychiatric brain diseases

  10. Indicators Reporting initiatives • Eurostat is in charge of the coordination of the new Commission report • 'Measuring progress towards a more sustainable Europe - Sustainable development indicators for the European Union (2007 Monitoring Report)'. SANCO will contribute to the Chapter on Public Health • ECHI National reports (32 Member States) • Sources of information (ECHI report by Member State) • Reporting and analysing health on a ECHI basis: • Template to be approved by this Working Party • Text to be approuved for national representative in this WP • ISARE Regional reports (400 regions) • Reporting and analysing health on a ISARE basis • Template to be consulted to this Working Party • Text to be proposed by experts (PHP contribution ?)

  11. Sets of indicators in the EU Public Health Policy National indicators: ECHI (European Community Health Indicators) Sub-national indicators: ISARE (Indicateurs de Santé dans les Régions de l’Europe) Urban indicators: EURO-URHIS (European system of urban health indicators) Structural indicators: Healthy Life Years Health Care Quality Indicators OCDE Project Environment & Health Indicators System ENHIS System (with WHO and EEA) Indicators on Social Protection ISG System (developed by DG EMPL) Sustainable Development Indicators SDS Indicators (developed by Eurostat)

  12. Improving mechanisms for health reporting with common methodologies and systems of collection of data accepted by all the Member States • Sustainable instruments • European Health Survey System (health interview and health examination surveys) • Revision of the International Classifications • To develop the System of Health Accounts • A common system of collection of information on hospital activities • eHealth dimension • Development of some disease registers (cancer, health and environment, etc.) • Collection of information on primary care • Sentinel networks • Short-term instruments • Instruments for short term information needs as the health modules in the Eurobarometer survey and other Eurostat data collection projects (E4SM)

  13. Improving mechanisms for health reporting with common methodologies and systems of collection of data accepted by all the Member States (Sustainable instruments) • European Health Survey System (health interview and health examination surveys) • The database HIS/HES • The European Health Interview Survey implemented by the Statistical Programme • The EHIS annual indicators would cover the prevalence of certain chronic diseases in past • twelve months; Body Mass Index (mainly overweight and obesity), hazardous alcohol consumption, • physical activity, smoking, consultations of doctors and dentists, medicine use, • preventative actions, selected physical and sensory functional • Limitations, pain and discomfort, SF-12 on mental health • The European Health Examination Survey implemented by the Public Health Programme and the FP7

  14. Improving mechanisms for health reporting with common methodologies and systems of collection of data accepted by all the Member States • Sustainable instruments • Human Biomonitoring (HBM) has been defined in the preparation of the Action Plan Environment & Health as "monitoring activities in human beings, using biomarkers, that focus on environmental exposures, diseases and/or disorders and genetic susceptibility, and their potential relationships". • ESBIO Project • The ultimate aim is to support environmental policy as well as public health policy by better data comparability and accessibility within and between countries and more effective use of resources through shared development of scientific tools and appropriate strategies.

  15. Improving mechanisms for health reporting with common methodologies and systems of collection of data accepted by all the Member States • Sustainable instruments • To develop the System of Health Accounts • OECD/Eurostat/WHO Joint Collection • The PHP supports Eurostat and OECD in refinement of SHA procedures • First results available in 2007 • A common system of collection of information on hospital activities • ISHT (International Short List Tablulation) from Eurostat/WHO/OECD on the basis of the Hospital Data Project • First results available in 2006 • Development of some disease registers • The EUNICE Project on cancer • The Health & Environment • Collection of information on primary care • Project with OECD • Sentinel networks • EISS (flu) • To be developed

  16. Improving mechanisms for health reporting with common methodologies and systems of collection of data accepted by all the Member States • Short-term instruments • Instruments for short term information needs as the health modules in the Eurobarometer survey • 5 modules in 2006 (mental well being, food, tobacco, medical errors, AIDS Prevention) • 5 modules in 2007 (EMF, risk factors, tobacco, alcohol, organ donation) • 1 module in 2008 (mobility of patients) • Eurostat data collection projects • The SILC survey is used for Healthy Life Years and Unmet needs • New survey 'E4SM' (European System of Social Statistical Survey Modules) since 2009

  17. Improving mechanisms for health reporting with common methodologies and systems of collection of data accepted by all the Member States Revision of international classifications Revision of the International Classification of Diseases (ICD): The WHO has launched the process of revision of the International Classification of Diseases (ICD) -10 to prepare the new ICD-11 which should be ready around 2015. The EC is very involved on the process from the side of the Rare Diseases. Discussions on the revision and improvement of the ICD will be also launched for the mental health disorders. Revision of the International Standard Classification of Occupations (ISCO): The ILO (International Labour Organisation) has launched the process of revision of the Standard Classification of Occupations (ISCO 88) which should be replaced by a new ISCO 08 to be completed in 2008. The revision of the Chapter on Health Professions could have a significant impact in all the surveys, registers and health accounts which uses ICO 88. Eurostat responsibility. Revision of the International Classification on Health Accounts (ICHA): The OECD, Eurostat and WHO agrees on the start of the process of revision of the ICHA (International Classification on Health Accounts) used for the creation of the SHA (System of Health Accounts).

  18. Health Reports The new Work Plan 2006 has given to the Health Reports a new impulse that was anticipated by the action of SANCO. The indicative calendar of production of health reports could be as follows: HEALTH REPORTS BASED ON INDICATORS - First Communicable Diseases Report First Semester 2007 Produced by the ECDC with the cooperation of SANCO C-2 and ESTAT - First Chronic Diseases Report Last Quarter 2007 Produced by TF MCD - First Global Report on Health in the European Union End 2008 Produced by the EUGLOREH Project leaded by the Ministry of Health (Italy) - Second report of the European Conference on Rare Diseases 2008 Produced by the RAPSODY Project leaded by EURORDIS

  19. The Work Plan 2007 previews also the possibility of selecting for funding health reports in the areas of: • gender specific health problems, • young people, the elderly, migrants, ethnic minorities, specific problems of social groups with low living standards • sexual and reproductive health

  20. How we will to disseminate the indicators? A part of the DG SANCO Web Site ‘Dissemination of Information and data’ (available in different phases since June 2005) EU Health Portal http://ec.europa.eu/health-eu/index_en.htm (launched in May 2006) All Member States languages will be available during 2007

  21. How we will to disseminate the indicators?

  22. New application to disseminate ECHI indicators

  23. New application to disseminate ECHI indicators

  24. New application to disseminate ECHI indicators

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