Joint Action on Monitoring Injuries in Europe (JAMIE) Meeting [place], [date], [year]

1. Joint Action on Monitoring Injuries in Europe (JAMIE) Meeting [place], [date], [year]

2. Why we need injury data • Informed decisions on priorities • Risk assessment • Targeted prevention • Risk communication • Monitor trends & effects Working together to make Europe a safer place

3. Policy questions • How common are injuries in Europe? • How common are injuries due to a specific cause? • How much variation is there between countries in injury incidence? Working together to make Europe a safer place

4. Who needs injury data? Working together to make Europe a safer place Working together to make Europe a safer place

5. Policy frameworks for EU-injury data exchange • EU Council Recommendation (2007/C164) (calls for ‘EU-wide injury surveillance exchange’) • EU Regulation on Community Health Statistics (2008/L354) (lists ‘accidents and injuries’ as one of the priority topics) • EU-Regulation on Market Surveillance (2008/L218) (requires MS’s to ‘monitor accidents caused by products’) • ECHI-29b indicator (2011) (requires HDR & ED-data on home & leisure accidents) Working together to make Europe a safer place

6. The injury pyramid for the EU Working together to make Europe a safer place Source: EuroSafe / KfV, 2009

7. Why we should collect injury data in hospitals and ED’s in particular - Hospitals see the more severe injuries compared to primary care. - Injury patients or accompanying persons can explain the circumstances. • Information can be collected on a large number of cases, at relatively low cost. Working together to make Europe a safer place

8. Where are we now? - All countries report on their deaths, but only little information on external cause. - Most/all European countries have national HDR, but not all include information on external cause of injury. • A few countries have national ED registers including external cause of injury (ICD). • A number of countries have injury surveillance systems recording in a sample of hospitals. Working together to make Europe a safer place

9. HDR registers that include information on external causes of injury • ICD-10 4 digits or more: Croatia, Republic, Estonia, Finland, Iceland, Latvia, Lithuania, Macedonia, Norway, Portugal, Slovenia, Sweden, UK. • ICD-10 3 digits or less: Austria, Hungary, Ireland, Luxembourg, Malta, Netherlands, Romania, Slovakia. • ICD-9 codes: Belgium, Greece, Italy, Spain. • NOMESCO: Denmark • No external cause information: Cyprus, Germany - Not known: Bulgaria, France, Poland, Turkey. - Specificity in reporting is a challenge: many cases ‘unspecified cause’. Working together to make Europe a safer place

10. ED register including information on external causes of injury (2011) - National or nearly complete: Denmark, Iceland, Macedonia, Norway, Slovenia, Sweden. • Sample of hospitals: Austria (9), Cyprus (1), Czech Republic (14), Germany (3), Italy (20), Latvia (19), Malta (1), Netherlands (12), Portugal (5), UK (13). • Pilot study on sampling: Belgium, Estonia, Finland, Hungary, Ireland, Luxembourg, Romania, Turkey. • No ED external cause data: Croatia, Greece, Lithuania, Slovakia, Spain. • Not known: Bulgaria, France, Poland, Turkey. (x)…number of hospitals Working together to make Europe a safer place

11. IDB level data collection on external causes of injury (planned for 2013 within JAMIE) - Austria (9) - Hungary (8) - Norway (3) - Croatia (?) - Iceland (1) - Poland (?) - Cyprus (1) - Ireland (3) - Portugal (6) - Czech Republic (14) - Italy (12) - Romania (6) - Denmark (3) - Latvia (19) - Slovenia (6) - Estonia (?) - Lithuania (12) - Spain (3) - France (?) - Luxembourg (1) - Sweden (7) - Germany (4) - Malta (1) - Turkey (14) - Greece (4)- Netherlands (12) - UK (13) Working together to make Europe a safer place

12. Challenges - Sample representativity. - Accuracy of data. • Depth of information. • EU-wide coverage. Working together to make Europe a safer place

13. JAMIE – Background and purpose • Need for data to support injury prevention and policy engagement • JAMIE provides a unique opportunity to improve injury prevention in Europe • Need to meet ESTAT requirements and contribute to European Community Health Indicators 29a and 29b) Working together to make Europe a safer place

14. The solution Develop a European injury surveillance system capable of answering policy questions, by: • Focusing on improvement of Emergency Departments data delivery • Implementing 2 levels of datasets (Minimum and Full) for collecting injury data at ED’s • Supporting countries in developing national and European burden of injuries estimates Working together to make Europe a safer place

15. Where are we Working together to make Europe a safer place

16. JAMIE – Objectives(Joint Action on Monitoring Injuries in Europe) • Agreed Data Quality Manual (by end 2011) • Increase in reporting countries (from 13 now to 22 by 2014) • To get four more countries committed to implementing IDB from 2014 onwards • To have in 26 countries competent and sustainable IDB centres by 2014 Working together to make Europe a safer place

17. The Minimum Data Set (MDS): external factors - Intent - Selected activities - Accidental injury - Paid work - Deliberate self harm - Sports - Assault related injury - Other - Other - Location (setting)- Selected mechanisms - Road - Road traffic injuries - Educational establishment- Fall - Home- Cut/pierce - Other - Poisoning - Burn/scalds - Other Working together to make Europe a safer place

18. IDB Full Data Set - Injury mechanism - Place of occurrence - Activity when injured - Type of sports when sport - Triggering product - Injury causing product - Details to road accident - Details to acts of violence - Details to acts of self-harm - Verbal description of incidence - National add-ons: e.g. use of personal protective equipements - Age & gender - Place of residence - Date of injury - Date of treatment - Diagnoses - Location of injury - Assignment to further treatment

19. Possible JAMIE implementations • IDB-FDS data collection at all hospitals • IDB-FDS data collection in a representative sample of hospitals • IDB data collection at one or a few hospitals + MDS data collection at all hospitals • IDB data collection at one or a few hospitals + MDS collection at a representative sample of hospitals Working together to make Europe a safer place

20. Network of NDA’sInjury Data Base • Members: the national data owners • Aim: develop robust data exchange in EU • Responsible for correct applications of IDB-data access policy Working together to make Europe a safer place

21. JAMIE implementations – current status • IDB data collection at all hospitals (inpatients only): Czech Republic, Latvia • IDB data collection in a (nearly) representative sample of hospitals: Austria, Netherlands, Sweden • IDB data collection at one or a few hospitals + MDS data collection at all hospitals: Denmark, Norway • MDS data collection in all hospitals: Iceland, Macedonia, Slovenia • MDS data collection in a representative sample of hospitals: None Working together to make Europe a safer place

22. Conclusions • JAMIE approach is a most practical way to unify injury data collection and surveillance in Europe • 22 Member States signed up for a joint effort to have by 2014 a common system in place • By 2015, all MSs should be able to provide ECHI-29b data Working together to make Europe a safer place

23. Ambition JAMIE To have by 2015: • Dedicated IDB-data administration centers in all EU-Member States • Delivery of national IDB-data to EuroStat made mandatory under Regulation 2008/L354 • IDB-data routinely being used for health and consumer protection policies in EU and Ms’s Working together to make Europe a safer place

24. https://webgate.ec.europa.eu/sanco/heidi/index.php/IDB Coordinating secretariat: EuroSafe w.rogmans@eurosafe.eu.com