Archive:Morbidity statistics methodology pilot studies - introduction

<Introduction: simple language, not too long, kind of executive summary>

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Executive summary

Eurostat activities in the domain of health status and health determinants are currently covered by surveys; however, one core activity is missing: the regular collection of diagnosis-specific morbidity data with incidence and prevalence rates. A legal basis for such data collection is provided by Regulation No 1338/2008 establishing a framework for Community statistics on public health and health and safety at work. That regulation foresees an implementation of morbidity statistics at EU level.

Eurostat’s commitment in developing the conceptual and methodological framework for establishing such data collection on morbidity has a long-standing tradition; however, this ambitious goal has not yet been achieved. The reason behind is that from a methodological and operational point of view, establishing morbidity statistics is an extremely complex exercise, in particular with regards to comparability of data across countries. To guide the MS in the piloting phase, detailed guidelines were produced by the Morbidity Statistics Development Group in 2007: for each entry in the recommended shortlist the appropriate measures on incidence and/or prevalence for data delivery were indicated. Each country had to find appropriate sources for producing best national estimates. The main criteria for the inclusion of a data source was statistical robustness on the main data quality parameters and hence permit reliable inter country comparisons. Hence, like many Eurostat statistics, the compilation of diagnosis-specific morbidity statistics is output driven and not source oriented.

Altogether 16 MS participated at pilot studies on diagnosis-specific morbidity statistic from 2005 to 2011. In 2011, Eurostat established the Task Force on Morbidity Statistics (TF MORB) for analysing the pilots’ results, especially in view of sources and best estimates. TF MORB is presenting this report with an indepth analysis of the pilot studies and methodological recommendations for paving the way ahead to overcome the pioneering stage.

The establishment of diagnosis-based morbidity statistics will be crucial for filling an information gap on the health status of the EU population which has severely hampered the development of public health indicators at EU level.

The draft of this report has been presented and discussed at the Technical Group on Morbidity in June 2013; the final version has been presented at the Working Group on Public Health Statistics (WGPH) in December 2013 which endorsed it.

The importance of having European statistics on diagnosesbased morbidity

Eurostat activities in the domain of health status and health determinants are currently covered by three surveys: the five-yearly European Health Interview Survey (EHIS); the newly established disability survey (European Survey on Health and Social Integration - ESHSI), and a basic set of health-related questions that are included in the annual EU Survey on Income, Social Inclusion and Living Conditions (EU-SILC).

However, one core activity is missing: the regular collection of diagnosis-specific morbidity data with incidence and prevalence rates. A legal basis for such data collection is provided by Regulation No 1338/2008 establishing a framework for Community statistics on public health and health and safety at work (5). That regulation foresees an implementation of morbidity statistics at EU level. The Community action Programme on Public Health 2008–13 and the Community Statistical Programme 2008–12 foresee the implementation of that Regulation as a key statistical element of a sustainable health monitoring system. In addition, the Commission Communication Solidarity in health also emphasizes the importance of having Regulations developed in each domain of public health statistics. (6)

The recent Commission staff working document Investing in health (7) (which is an accompanying document to the ‘Social Investment Package’ defines the role of health as part of the Europe 2020 policy framework and points out that an improvement in health data collection is needed, in particular in using the European Core Health Indicators (ECHI) and developing tools to better assess the efficiency of health systems. In addition, the statistical information on specific chronic diseases is a key component in underpinning and addressing policies to improve the labour market participation, risk of social exclusion and risk of poverty.

Eurostat’s commitment in developing the conceptual and methodological framework for establishing a data collection on morbidity dates back to the mid-nineties. Following the analysis of pilot studies in 16 Member States this report of the Eurostat Task Force on Morbidity (TF MORB) is now paving the way ahead to overcome the pioneering stage with a set of recommendations.

The feasibility of such statistics, in particular in view of using data from different sources, will be markedly enhanced by the current revision of the EU statistical law (8). It will be the legal basis to ensure and encourage a better use of existing sources by improving access to and exploitation of administrative data, e.g. by merging or linkages of the existing datasets.

The establishment of diagnosis-based morbidity statistics is crucial for filling an information gap on the health status of the EU population. Key elements of innovation for that approach are:

the best estimates from multiple sources that can be used (namely physicians issuing

diagnoses/prescriptions or health records from registers, health institutions and insurances)

the possibility to compare best estimates on incidence and prevalence of diseases
the comprehensive coverage of morbidity data
the coverage of the whole population, by providing national estimates, and
diseases and conditions to be reported in terms of EU relevance and the Public Health perspective.

In 2007 Eurostat and Member States (MS) developed a methodology and a shortlist for collecting such data at EU level. It addresses diseases and conditions with major impact on health care and health-care related costs, annual death rates, or potential years of life lost. Examples range from heart/circulatory and respiratory diseases, cancer or metabolic diseases such as diabetes to mental diseases, injuries and their consequences and

Acknowledgments

Production

Authors and members of the Task Force ‘Morbidity’: Monica Pace (1)(2), Hartmut Buchow (1), Margarida Domingues de Carvalho (1), Willem Aelvoet (2), Jacques Bonte (2), Gráinne Cosgrove (2), Rita Gaidelyte (2), Mika Gissler (2), Georgeta-Marinela Istrate (2), Merike Rätsep (2), Ieva Strele (2), Bogdan Wojtyniak (2).

Former members of the Task Force ‘Morbidity’: Prof. Howard Meltzer (3), Anne Fagot-Campagna (3), Jean-Marc Schaeffer (1).

Layout and dissemination

Isabelle Fiasse (4).

(1) Eurostat, Directorate F ‘Social Statistics’.

(2) Monica Pace is Seconded National Expert from the Italian National Institute of Statistics, Willem Aelvoet is from the Belgian Federal Public Service Health, Jacques Bonte Private Expert, Gráinne Cosgrove is from the Irish Department of Health, Rita Gaidelyte is from the Lithuanian Institute of Hygiene, Mika GIissler is from the Finnish National Institute for Health and Welfare, Georgeta-Marinela Istrate is from the Romania National Institute for Statistics, Merike Rätsep is from the Estonian National Institute for Health Development, Ieva Strele is from Riga Stradins University, Riga, Latvia, Bogdan Wojtyniak is from the National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.

(3) Former members of the Task Force Morbidity: Prof. Howard Meltzer was from the Department of Health Sciences College of Medicine, Biological Sciences and Psychology University of Leicester, UK (member until September 2012), Anne Fagot-Campagna was from the French Institute for Health Surveillance (member until March 2012), Jean-Marc Schaeffer Eurostat, Directorate F ‘Social Statistics’ (member until April 2012).

(4) Eurostat, Directorate B ‘Methodology; corporate statistical and IT services’.

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[[Category:<Health>|Morbidity statistics methodology pilot studies - introduction]] [[Category:<Statistical article>|Morbidity statistics methodology pilot studies - introduction]]