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PubMed1994

[Demographic aging in the member countries of the European Union].

"Despite all remaining political, economical and cultural differences in the member countries of the European Union...population ageing is a common phenomena of all these countries.... Many spheres of socio-economic life in the countries of the European Union are already affected by this shifting process.... Most of the social security and welfare systems of the industrialized countries in the European Union are mainly based on intergenerational solidarity, a solidarity which is highly burdened by the demographic development. In this respect policy makers have to take into consideration the expected changes in the age structure of the economically active population, changing patterns of labour force participation as well as changes in family and household structures in their task to modify existing systems or to build new systems of social security and welfare under the growing burden of an ageing society." (SUMMARY IN ENG)

Demography↗
PubMed2000

Health technology assessment and health care in the European Union.

The papers on the 16 European countries presented in this issue show their great diversity of health systems. Health technology assessment (HTA) has been institutionalized in a number of members of the European Union and has a growing impact on health policy. A remaining challenge is to see HTA visible and useful at the European level, which requires more active coordination of national and regional activities. A network of HTA programs and researchers has been established. The HTA-Europe Steering Committee has suggested a number of actions by the European Commission to promote further coordination. The most important conclusion of the HTA-Europe report is that a permanent coordinating structure is needed at the European level.

Delivery of Health Care↗
PubMed2003

Geriatric medicine in the European Union: unification of diversity.

The numbers of older people in the European Union are increasing and, with their associated health needs, there is a requirement for the specialty of Geriatric Medicine to be available throughout Europe. At present, specialists in Geriatric Medicine are not recognised in some of the European Union member countries. It is imperative that training in Geriatric Medicine should take place throughout Europe, starting at undergraduate level and progressing through postgraduate training. There must be a programme of continuing medical education and personal development. This paper highlights some of these challenges and suggests a possible way forward.

Accreditation↗
PubMed1996

Animal health and the trade in aquatic animals within and to the European Union.

The creation of a single European market has significantly extended the scope of veterinary animal and public health legislation. This extension includes aquatic animals, and a comprehensive set of directives and decisions has been developed to ensure free circulation of aquaculture animals and their products, while guaranteeing a high level of animal health. At the same time, and in the same context, other directives have been adopted which organise checks on animals and products within and to the European Union (EU), as well as accompanying financial measures. Animal health legislation for the movement of aquaculture animals is also based on a number of principles, including the following: --the definition of important pathogens and their hosts --zoning (regionalisation)--the obligation for EU Member States to move animals only from areas or farms with high health status to and between areas and farms with equal or lower health status--the prescription of a testing regime to improve animal health status in zones or farms. In addition, disease control prescriptions have been established or are being considered for adoption. These include the establishment of national and EU reference laboratories, as well as the application of contingency plans and the measures to be taken in the event of a disease outbreak.

Animals↗
PubMed2005

Health impact assessment: assessing opportunities and barriers to intersectoral health improvement in an expanded European Union.

On 1 May 2004 the European Union (EU) underwent unprecedented enlargement, from 15 to 25 countries, increasing its population by 20% to over 450 million. Although EU law has limited specific competence in the area of health, its influence on other policy sectors such as agriculture, trade, and employment has wide ranging implications for health. Yet with the exception of provisions on communicable disease control and food safety, public health considerations have played little part in negotiations on EU accession. This paper argues for an intersectoral public health approach in the expanded EU. It reviews the legal basis for assessing the health impacts of policy in the EU and, using health impact assessment as a case study, it examines how well the new member states may be prepared to tackle intersectoral public health action within the constraints imposed by EU policy.

European Union↗
PubMedDate not supplied

KAMEDO report no. 83: European Union Summit in Göteborg, 2001.

A European Union (EU) Summit in Göteborg, Sweden, was held 15-16 June 2001. This meeting presented various security and medical concerns to city officials. In preparation for a large meeting such as the EU Summit, a plan should be established that includes basic facts, management organization, and guidelines. Clear communication beteween city agencies also must be established. Hospital inventories should be recorded daily and reported to medical staff. A command center must be in place for police and medical command. An emergency medical provider should ride in each police vehicle, so in case of a riot situation, victims can be treated quickly. An information officer should be assigned with the task of providing information regarding the injured to the media.

Congresses as Topic↗
PubMed2004

Pharmaceutical pricing, price controls, and their effects on pharmaceutical sales and research and development expenditures in the European Union.

BACKGROUND: Each country in the European Union (EU) currently employs direct price controls or permutations of direct price controls, such as reference pricing or limitations on returns to capital. Some countries also use volume controls. A new proposal that is being discussed would have all of the countries in the EU adopt uniform pricing for each pharmaceutical. OBJECTIVE: This paper analyzes the economic effects of free-market pricing individual-country price controls, and uniform EU price controls. METHODS: Microeconomic and mathematical models were used to simulate and predict probable economic outcomes in a comparative static setting. RESULTS: Price controls may be in the form of price ceilings or price floors. Both forms of price control generate deadweight economic losses in the short run and long run. A uniform EU price for each pharmaceutical sold there would have elements of a price ceiling in some of the countries and of a price floor in other countries. The deadweight loss incurred would be a function of the level at which the uniform price was set by the EU and the price elasticity of demand for each pharmaceutical in each country. CONCLUSIONS: Economic efficiency is maximized in both the short run and long run when prices are set in freely competitive markets. An additional important dimension of Ramsey pricing within a competitive context is that it generates funds for investment in pharmaceutical research and development, which enhances economic efficiency in the long run.

Cost Control↗
PubMed2004

Evidence-based medicine breaking the borders--a working model for the European Union to facilitate evidence-based health care.

The promotion of evidence-based health care to improve quality of care has become an important political agenda worldwide. In April 2003 the European Commission acknowledged the lack of evidence-based health care in the European Union. Nevertheless, neither the new eHealth 2005 Action Plan nor the Public Health Program 2003 explicitly state the facilitation of evidence-based health care as a goal. This article proposes a working model for a network of institutions and databases within the European Union to facilitate evidence-based health care. The model strives to adapt existing U.S. examples of institutions in the field of evidence-based medicine, like Evidence-based Practice Centers, and the National Guideline Clearinghouse to the heterogeneous and legally restrictive environment of the European Union, particularly Article 152 of the European Union Treaty. In addition to increasing efficiency and decreasing redundancy, coordinating national efforts in best practice will also facilitate information sharing and knowledge transfer. The establishment of databases in native languages could also break down one of the main barriers existing between care providers and evidence-based medicine while adhering to the overall concepts of eHealth 2005.

Databases as Topic↗
PubMed2006

A critical assessment of the European Commission's proposals for the risk assessment and registration of chemical substances in the European Union.

In May, 2003, the European Commission published detailed proposals relating to its 2001 White Paper--Strategy for a Future Chemicals Policy. The White Paper described a new registration system called the REACH (Registration, Evaluation and Authorisation of Chemicals) system, for both new and existing chemicals. Subsequently, these detailed proposals were available for an eight-week consultation period for stakeholders to voice their views and concerns. In this paper, we describe our reactions to the Commissions more-detailed proposals. These include the creation of a European Chemicals Agency to implement the REACH system in conjunction with Competent Authorities (CAs) in Member States and the Commission itself. Unfortunately, many of our concerns and suggestions, previously voiced and shared with several other key stakeholders, remain unanswered, but are as relevant as when the White Paper was published. In particular, we are concerned about the lack of a clear and coherent strategy. There is no guidance for registrants on intelligent testing to maximise the use of non-animal approaches to safety testing, based on a combination of factors for estimating exposure levels, rather than mainly on production volumes. We are also concerned about the absence of a clear programme for the development, improvement and validation of new alternative methods, in conjunction with the Commissions own unit, the European Centre for the Validation of Alternative Methods, as well as other organisations with relevant expertise and experience, including FRAME. Finally, we explain why such measures should be introduced, together with clearer guidelines for the respective roles of the Agency, the CAs and the Commission in implementing and harmonising the REACH system at the European Union and Member State levels. A series of recommendations are made, to improve the situation and to improve the risk assessment process.

Journal Article↗
PubMed2002

European Society of Intensive Care Medicine statement: intensive care medicine in Europe--structure, organisation and training guidelines of the Multidisciplinary Joint Committee of Intensive Care Medicine (MJCICM) of the European Union of Medical Specialists (UEMS).

This article describes the structures and institutions in the European Union by which professional training and qualification in medical specialities will be harmonised. All main medical specialities are represented in the European Union of Medical Specialists (UEMS) by speciality sections. For intensive care medicine, as a multidisciplinary speciality, a new structure of a Multidisciplinary Joint Committee of Intensive Care Medicine (MJCICM) within the UEMS was established in 1999. In this MJCICM the European Society of Intensive Care Medicine and the European Society of Paediatric and Neonatal Intensive Care are represented by delegates without voting capacity in a Standing Advisory Board. Statements and recommendations which the MJCICM has worked out until now are presented: Definitions of intensive care medicine, structural conditions for education and training, continuing medical education, criteria for accreditation of intensive care medicine training centres, common core curriculum for optional specialist training in intensive care medicine, as well as an intensive care units accreditation visiting programme and standards for medical treatment and nursing care.

Accreditation↗
PubMed2003

Control and eradication of O.I.E. list A diseases--the approach of the European Union to the use of vaccines.

In the last decade the European Union has experienced serious outbreaks of certain O.I.E. list A diseases such as foot-and-mouth disease, classical swine fever and avian influenza. These diseases have been controlled and eradicated by means of culling and destroying a very large number of animals, which has been very expensive and has raised ethical questions. In accordance with existing rules, emergency vaccination has also been applied under certain circumstances, but its use has often been hampered by the impossibility of distinguishing vaccinated but healthy animals from the infected ones and by its negative impact on the trade of the vaccinated animals and their products. Marker vaccines and suitable accompanying discriminatory tests may overcome these problems and be used as additional eradication tools, where appropriate. Provisions on the use of these tools have already been introduced in the legislation of the European Union.

Animal Diseases↗
PubMed2001

Sports injuries among children in six European union countries.

Since sports participation entails the risk of injuries that account for substantial morbidity and disability, the existence of adequate epidemiological information is essential for the development of sound preventive strategies. In this study, we present data on the occurrence of sports injuries among children in six European countries, namely Austria, Denmark, France, Greece, The Netherlands, and the United Kingdom. An operational definition for sports injuries was developed, and comparable data from the European Home and Leisure Accident Surveillance System, an established injury surveillance system operating in 12 European union countries, were collected from the participating member states, during a 1-year period (1998). Sports injuries were examined in schools, in organised and unorganised settings, and in specific types of sports by demographics and injury descriptive variables. Sports injuries represent a quantitatively important and sufficiently serious problem in European union countries, accounting for an estimated annual number of about a quarter of a million outpatient visits in two of the participating countries, which provide national estimates. It is evident, that sport injuries are not only common but also injuries of considerable severity, since a large fraction represents fractures, while approximately 4% of the total require hospitalisation. Football and basketball among male children are, in declining order, the two sports responsible for the most frequent injuries in the European union countries, whereas gymnastics and volleyball prevail among females. The study indicates the importance of injury surveillance in describing the epidemiology of sports injuries and provides an estimate of the magnitude and the profile of sport injuries that take place annually in European union countries.

Adolescent↗
PubMed2002

Voluntary health insurance in the European Union: a critical assessment.

The authors examine the role and nature of the market for voluntary health insurance in the European Union and review the impact of public policy, at both the national and E.U. levels, on the development of this market in recent years. The conceptual framework, based on a model of industrial analysis, allows a wide range of policy questions regarding market structure, conduct, and performance. By analyzing these three aspects of the market for voluntary health insurance, the authors are also able to raise questions about the equity and efficiency of voluntary health insurance as a means of funding health care in the European Union. The analysis suggests that the market for voluntary health insurance in the European Union suffers from significant information failures that seriously limit its potential for competition or efficiency and also reduce equity. Substantial deregulation of the E.U. market for voluntary health insurance has stripped regulatory bodies of their power to protect consumers and poses interesting challenges for national regulators, particularly if the market is to expand in the future. In a deregulated environment, it is questionable whether this method of funding health care will encourage a more efficient and equitable allocation of resources.

Economic Competition↗
PubMedDate not supplied

[Continuing medical education in Croatia and the European Union].

The Continuing Medical Education (CME), with attention to other forms of Continuing Professional Development (CPD) in Croatia and the today endeavors in the European Union, are presented. In European Union the formal CME is in its starting. The "European Accreditation Council for Continuing Medical Education" (EACCME) of the UEMS is established, which has formulated the principles of continuing education, the credit hours and their realizing, that would enable the mutual recognition of education in all European countries. In Croatia the starting of CME was at beginning of the 20th century, when the professional societies of Croatian Medical Association were founded. CPD was almost exclusively connected to activities of "Andrija Stampar" School of Public Health, to the School of Medicine in Zagreb and partly in Rijeka, which established a great number of postgraduate studies. The CME i.e. the courses of education were tightly connected to activities of the Croatian Medical Association, of its professional societies and its Academy of Medical Sciences, but also to activities of School of Medicine in Zagreb and Rijeka, and recently in Split and Osijek. Since 1995 the third partner, the Croatian Medical Chamber joined too. The number of CME meetings during 1998 is presented. The approximate calculation for needed annual courses of CME for all medical specialties in Croatia is presented. The formation of the National Authority for CME is suggested, in which all the interested institutions should be represented.

Croatia↗
PubMedDate not supplied

Physical requirements associated with the work of aging workers in the European Union.

Physical requirements of work should decline with advancing age because the dimensions of physical work capacity of individuals decline with age, too. The Second European Survey on Working Conditions in 1995/1996 was used to study the prevalences (%) of poor work postures, handling heavy loads, and repetitive work in the representative sample of employed people in the 15 European Union member states. Exposure to physical requirements was still common in the European Union. Nearly 50% of older workers (age 45 years or more) were exposed to repetitive work, about 30% had poor work postures and 15% to 20% were handling heavy loads at least half of the working time. The physical requirements were as common for older and younger (less than 45 years of age) workers. The physical requirements were most common in Mediterranean countries and least common in the northern part of Europe. The differences in prevalence rates of exposures between the countries were large, from three- to fivefold. Favorable differences between older and younger workers were more notable for older men than for older women in poor work postures and repetitive work. However, older women had less handling of heavy loads than older men. The results showed that the need for better adjustments of physical requirements with age is still very relevant in the European Union and demands urgently appropriate measures in working life.

Adult↗