Addressing the health needs of frail elderly people: Ontario's experience with an integrated health information system.
Explore the source record for details and available documents.
Aged, 80 and over↗
SEARCH · PubMed Health
Results for “Public Health Informatics”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Information from primary care: its importance and value. A comparison of information from Slovenia and England and Wales, viewed from the 'Health 21' perspective.
BACKGROUND: The WHO have set health standards in the form of 21 targets--Health 21--and the EU are developing a set of health indicators whereby national health status can be measured. Data from Slovenia and from England and Wales assessing information systems in primary care and their capacity to deliver the requirements of these initiatives have been examined. In both countries, primary care is provided through a state-led service. METHODS: Consultation data from the annual report of the Department of Health Slovenia (1999) are compared in respect of relevant targets with data from the Fourth National Morbidity Survey (1992) in England and Wales. Consultation rates were standardized to the European Union 15 country population (1998). RESULTS: Consultation rates in females were similar in the two countries whereas in males rates were higher in Slovenia. The proportionate distributions of consultations by chapter of the International Classification of Diseases (ICD) were similar in both countries, respiratory (17%) and musculoskeletal (9%) disorders ranked first and second. For eye diseases, injury and poisoning, factors influencing health status (e.g. medical examination). proportions were higher in Slovenia: for mental disorders higher in England and Wales. The relativity of male to female consultation rates was broadly similar with higher rates in females in most ICD chapters. These differences are considered in detail against the background of WHO targets. CONCLUSIONS: Data gathered systematically from the surveillance of consultations in primary care are important to the measurement of WHO 'Health 21' targets.
Adolescent↗
Rising multiple maternity rates and medical management of subfertility: better information is needed.
Multiple maternity rates rose rapidly from the mid-1970s onwards in many Western countries. This has major public heath implications, as multiple pregnancies can lead to many problems for the mothers and their children. Ovarian stimulation and assisted reproductive technology (ART) play a major role in these trends but there are few data about them. Consistently defined multiple maternity rates, including twin and triplet maternity rates are needed annually for each country in order to monitor time trends and make international comparisons. In order to assess the contribution of ovarian stimulation and ART to trends in multiple maternities and to monitor their impact on pregnancy outcome, fuller and more consistent data are needed. These could be collected from ART centres and other care providers, or through medical birth registries or national surveys.
Data Collection↗
Monitoring health in Europe: opportunities, challenges and progress.
Explore the source record for details and available documents.
Europe↗
The ECHI project: health indicators for the European Community.
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.
Community Health Services↗
Cancer control in Europe: a proposed set of European cancer health indicators.
Explore the source record for details and available documents.
Databases, Factual↗
Health indicators in the European Regions.
Explore the source record for details and available documents.
Databases, Factual↗
Assessing comparability of dressing disability in different countries by response conversion.
BACKGROUND: Comparability of health data is a major challenge within the context of the Health Monitoring Programme of the European Commission. A common problem in surveys is that many variations of essentially the same question exist. METHODS: Response conversion is a new method for improving comparability by scaling the data onto a common scale. Comparisons between member states can then be made in terms of the common scale. A first step is the construction of a conversion key. This is a relatively complex activity, but needs to be done only once. The second step is the actual data transformation. This is simple, and can be repeatedly done on a routine basis as new information arrives. Construction of the key is only possible if enough overlapping information can be found. RESULTS: The method is illustrated for dressing disability from five European countries. Differences occur between countries, between sexes and between age groups. These were similar in magnitude. CONCLUSION: Response conversion is a new method for enhancing comparability among existing data. Conversion can only be done if a key is available. More work is needed to establish the technique. Future implications within the Health Monitoring Programme are discussed.
Activities of Daily Living↗
International monitoring of musculoskeletal complaints: a need for consensus.
Musculoskeletal pain is the complaint most frequently reported in health interview surveys. There is a confusing magnitude of names given to musculoskeletal pain complaints reflecting diverging opinions and a lack of consensus of what it is all about. This article discusses how to monitor the occurrence of unspecified musculoskeletal complaints and possible sources of information are presented. The main focus of the article is on how to include musculoskeletal complaints in health interview surveys, and a standard question to be included in all general health questionnaires is recommended.
Chronic Disease↗
European food availability databank based on household budget surveys: the Data Food Networking initiative.
BACKGROUND: There is a need in Europe for sources of dietary data that would provide a regular flow of comparable nutrition information. In this context, the Data Food Networking (DAFNE) project has been developing a cost-effective food databank that allows monitoring of food availability within and between countries. METHODS: The DAFNE project has developed a common classification system for the food and socio-demographic variables recorded in the national household budget surveys. Daily individual food availability was estimated for each participating country and basic descriptive statistics were used to depict the nutritional habits of the populations. RESULTS: The DAFNE databank is freely accessible through DafneSoft (www.nut.uoa.gr). Three figures, based on Greek, Norwegian and UK data respectively, were selected to indicatively present the potential of the DAFNE data in order to monitor changes in the availability of 12 food groups over time; to study the effect of education in the total added lipid availability; and to follow time changes in fresh vegetable availability between manual and non-manual households. CONCLUSION: The HBS data allows the highlighting of issues related to nutrition surveillance. The application of the DAFNE methodology in developing a databank of standardized dietary data offers a realistic option for monitoring dietary habits in Europe. Benefiting from this potential, the European Union may additionally consider the undertaking of a pan-European individual dietary survey, in a sub-sample of the household budget population.
Budgets↗
PERISTAT: indicators for monitoring and evaluating perinatal health in Europe.
BACKGROUND: The PERISTAT project aimed to develop an indicator set for monitoring and describing perinatal health in Europe. The challenge was to define indicators that cover common concerns and have the same meaning within the different European health care systems. METHODS: PERISTAT included i) a review of existing recommendations on perinatal health indicators, ii) a DELPHI consensus process with a scientific advisory committee composed of a clinician and an epidemiologist or statistician from each European member state as well as with a panel of midwives, and iii) a study of the availability of national statistics to construct recommended indicators. This article describes the first two components. RESULTS: The review identified 10 international and 13 national recommended indicator sets. It also included indicators routinely compiled by WHO, EUROSTAT and OECD. Because of the methodological limits to using existing indicators for European comparisons, a high priority was placed on improving indicators already collected. Using the DELPHI method based on the results of the review, the scientific committee achieved a consensus on ten core and 23 recommended indicators, including 12 requiring further development. CONCLUSIONS: The PERISTAT project was successful in identifying a set of indicators, which drew on and consolidated previous work. Consensus was not achieved on precise indicators in areas where uncertainty about appropriate indicators was high, although areas were targeted for future development. Finally, the feasibility study, which is in progress, is an essential part of the project, since it will enable member states to evaluate their capacity to produce these indicators.
Congenital Abnormalities↗
Child health indicators for Europe: a priority for a caring society.
BACKGROUND: Measurement of children's health is important for two reasons: first, because young people are citizens in their own right, yet largely unable to act as self-advocates, particularly at the population level; and second, because their health determines the health of the future population. Indicators based on measurements of child health are important for identifying progress, problems and priorities, changes over time, and newly emergent issues. The European Community Health Monitoring Programme (HMP) is a comprehensive programme to develop and implement a set of national-level indicators. The Child Health Indicators of Life and Development (CHILD) project is the only population group-specific project, seeking to determine a holistic set of measures. METHODS: The project endeavoured to address all aspects of child health and its determinants, balancing positive and negative aspects. It undertook a structured search of published evidence to seek to identify, and validate, indicators of health and illness, health determinants and challenges to health, quality of healthcare support and health-promoting national policies. A systematic approach was used in identifying valid indicators, and in assembling a balanced composite list. All ages from infancy to adolescence were covered. RESULTS: The project's final report identifies 38 core desirable national indicators, citing purpose and evidence for each. Of equal importance, it also identifies 17 key child health topics on which further research work is needed in order to identify and validate indicators appropriate across different national settings.
Adolescent↗
Health indicators for people with intellectual disabilities: a European perspective.
People with intellectual disabilities make up about 1% of the population of Europe. As trends toward community life advance, they have become more visible and more likely to access generic health systems. Yet evidence suggests that there are striking disparities between the health of this group and that of the general population. Increased longevity means that adults in this group expect to live longer lives and thus to encounter age-related risks for various health conditions. The 'Pomona' project, funded by the EU Health Monitoring Unit, aims to develop a set of health indicators for people with intellectual disabilities. It will build on the work accomplished by the team developing ECHI--European Community Health Indicators. This article outlines the rationale for the project, key elements in its implementation and expected outcomes.
Demography↗
European Union diabetes indicators: fact or fiction?
Diabetes mellitus is one of the major causes of morbidity and mortality in EU/EFTA countries. Monitoring risk factors for diabetes and its complications will offer the possibility to evaluate the development in time as well as the influence of possible interventions. In this investigation a list with core and secondary indicators is proposed. Availability of these indicators and their data sources is discussed. An important variability of data sources is used in EU/EFTA countries, interfering with the comparability of the outcome. Further harmonisation as well as continuous evaluation of data sources will be necessary to provide reliable tools to monitor diabetes mellitus and its outcome on a routine basis.
Comorbidity↗
Creating a coherent set of indicators to monitor health across Europe: the Euro-REVES 2 project.
The Euro-REVES 2 project, 'Setting up of a coherent set of health expectancies for the European Union', was begun in 1998 under the European Health Monitoring Programme with the aim of selecting a concise set of instruments to simultaneously monitor mortality and the different facets of health. An in-depth analysis of the current health survey instruments in Europe together with a review of past research, found that, although harmonization in instruments appeared to exist superficially, major differences existed. Four instruments have been recommended (where necessary using existing instruments with modifications suggested by the research literature) covering physical and sensory functional limitations, activity restriction, self-perceived health and mental health. Additionally a new global activity limitation indicator (GALI) has been developed. These instruments are firmly anchored to past research and the health concepts behind the indicators and their relevance to policy and guidelines for implementation are explicitly made. The second phase of the project will recommend further instruments, leading to health expectancies that cover all the conceptual framework of population health measurement. This will allow assessment of health inequalities between the European Union countries, an appreciation of the causes and the production of profiles for each country in terms of the various facets of health.
Activities of Daily Living↗
The comprehensive cancer monitoring programme in Europe.
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.
Cost of Illness↗
Evaluation of Health Interview Surveys and Health Examination Surveys in the European Union.
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.
Databases, Factual↗
The Hospital Data Project: comparing hospital activity within Europe.
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.
Diagnosis-Related Groups↗