The EU called for greater consistency in high quality and fully comparable information. Eurostat and Directorate General for Health and Consumer Protection (DG SANCO) have outlined their recommendations to help achieve this goal: suggesting a common framework should be adopted so that this health information should have relevance on an EU level:
A sound and internationally agreed set of international classifications (e.g. International Classification of Diseases (ICD), International Classification of Functions (ICF), International Classification of Health Accounts, etc.)
Operational systems for collection of data on the state of health of populations (health surveys, information on hospitals, disease-specific registers, organisations holding data on patients, etc.)
Summary measures and population health indicators.
The lack of comparability in the current system of information collection is a result of different national health policies and systems having individual operational systems for collecting data. These differences along with differences in traditional approaches to statistics lead to disparities in data. The creation of a common and comparable framework within the EU ensuring minimum requirements for comparability of health status data will require conceptual clarity, a common set of domains/attributes, comparable resources or procedures, translation of concepts and wording, survey design (sampling, survey implementation, full coverage of the population, procedure for non-response, proxy interviews), commonly agreed reference periods, reliability and validity, etc.
DG SANCO suggest that the first phase of the data management should encompass:
an inventory of sources and methods over the entire EU;
an analysis of data needs in the respective fields;
a definition of indicators and quality assurance;
technical support for activities at national level;
data collection at EU level;
deporting and analysis
dissemination of results.
The outlined second phase would involve the previously defined indicators or the -databases would be used more routinely. At this stage where a lot of data will be -collected, the close collaboration with Eurostat will be very important.
The EU is focusing on certain areas in order to maximise the European added value:
The European Health Survey System
The European Health Examination Survey
Information collection system for : hospital activities
Improving disease-specific registers
One of the highest priorities for Eurostat and DG SANCO is to expand their actions under the European Health Survey System. The EHSS was agreed by the Directors of Social Statistics (DSS) in 2002 and supported by the Network of Competent Authorities on Health Information (NCA) as a framework for a regular collection of harmonised data – allowing inter-country comparisons – by means of surveys and/or survey modules on health. The aim of the EHSS is to set up a system for health data collection via population surveys in order to respond to the information needs of Europeans on the topics of health and health determinants. The main components of the EHSS are:
The European Health Interview & Health Examination Surveys Database (EUHSID) of standard certified and recommended reference instruments (available at national and EU level).
The European Health Interview Survey (EHIS), managed by Eurostat under the Community Statistical Programme. The EHIS is planned to be held every five years with the first round of the EHIS taking place in 2007/2009 in all the EU Members States. It will include common survey modules and the Mini European Health Module implemented in the (annual) EU-SILC (Statistics on Income and Living Conditions) also managed by Eurostat under the Community Statistical Programme. This is actually used to calculate the structural indicator Healthy Life Years.
A European Health Examination Survey (being developed under the responsibility of DG SANCO in the framework of the Community Health Programme and the FP7 Programme).
On the issue of communicable diseases this kind of pan-European information is of great use. The Commission has recently strengthened the communicable diseases alert system by: a first update to the Early warning system which links the EU alert system with that of the World Health Organisation. A second update to the list of communicable diseases including: Severe Acute Respiratory Syndrome(SARS), avian influenza and the west Nile Virus, now a list of 47 diseases. Case information has been updated to keep in line with the newest scientific knowledge. This is an example of where increased co-ordination and comparable information has yielded EU wide standardised information in keeping with the goals and framework of the commission.
For Further Information
White Paper COM(2007) 630 final "Together for Health: A Strategic Approach for the EU 2008-2013
