DEVELOPMENTS ON THE DISSEMINATION OF THE EUROPEAN COMUNITY HEALTH INDICATORS

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DEVELOPMENTS ON THE DISSEMINATION OF THE EUROPEAN
COMUNITY HEALTH INDICATORS

• Luxembourg, 1st June 2007
• Antoni Montserrat
• European Commission
• DG SANCO Health Information Unit

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• 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

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• 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.

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• 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.

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• 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.

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• 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

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• 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.

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• 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 its 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.

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• 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

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• 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
  ?)

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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 lEurope) 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)

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• 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)

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• 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

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• 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.

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• 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

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• 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

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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).

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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
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• 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

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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 (laun
ched in May 2006) All Member States languages
will be available during 2007

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How we will to disseminate the indicators?

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New application to disseminate ECHI indicators
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New application to disseminate ECHI indicators
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New application to disseminate ECHI indicators