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PubMed2003

Coronary and cerebrovascular population-based registers in Europe: are morbidity indicators comparable? Results from the EUROCISS Project.

BACKGROUND: The EUROCISS Project (European Cardiovascular Indicators Surveillance Set), as part of the Health Monitoring Programme financed by the European Commission, has been implemented to develop health indicators and recommendations for the monitoring of cardiovascular diseases (CVDs). Morbidity data are rarely available in the different countries and when available, they are very rarely comparable. The aims of this paper are to list the existing population-based registers of acute myocardial infarction (AMI) and stroke in Europe, describe their methodology, and discuss their comparability. METHODS: using a questionnaire a comprehensive and updated picture on available sources of information, data, indicators, and methods were collected for population-based registers. The information requested generally included: the studied disease; the scope of the study (geographical area, temporal duration, age range, population); adopted methodologies (case definition, ICD coding for mortality and hospital discharge records, linkage and validation methods); morbidity indicators (attack rate, incidence, prevalence, case fatality rate). RESULTS: Belgium, Denmark, Finland, France, Germany, Italy, Norway, Spain, and Sweden have ongoing population-based registers for AMI. Denmark, Finland, France, Germany, Italy, Norway, and Sweden have ongoing population-based registers for stroke. Selection procedures of events, differences in age range, different validation procedures and methods make the results from these registers difficult to compare. CONCLUSIONS: Population-based registers provide the best indicators for AMI and stroke, such as attack rate and case fatality. Registers cover large samples of the population, usually regions or large municipalities. The comparability of data across countries depends on standardization, case definition, completeness, proper linkage, common diagnostic criteria and validation procedures. Given the high burden of AMI and stroke, efforts are needed in implementing registers in all European countries.

Cerebrovascular Disorders↗
PubMed2003

Work-related health monitoring in Europe from a public health perspective.

BACKGROUND: In contrast to the enormous importance of work to the life of humans and societies, the working environment has so far played only a minor role in health monitoring. However, increasingly it is realized that work has a strong public health impact and therefore is also a cost factor to modern societies. The aim of the project WORKHEALTH, which is currently being carried out under the EU health monitoring programme, is the establishment of indicators for work-related health monitoring in Europe from a public health perspective. WORKING PROCEDURE: The work will be carried out by means of three work packages: a synopsis of existing work-related indicator sets together with the identification of areas still to be developed, resulting specification of new indicators for work-related health monitoring, and the development of operational definitions for these indicators. The project includes strong links to the fields of occupational health and safety, public health, social insurance and labour inspectorates to include demands from, as well as to disseminate results to, these different institutions also involved in aspects of work-related health monitoring. EXPECTED RESULTS AND CONTRIBUTIONS: Expected results will be indicators for work-related health monitoring that have been developed jointly with the participation of all Member States and different stakeholders within this field, and which permit comparable and reliable data at a national as well as European level.

Europe↗
PubMed2003

Strengthening the public health system for a healthier future.

On November 6, 2002, Grantmakers In Health (GIH) convened a group of experts from the fields of philanthropy, research, government, and policy to examine the nation's public health infrastructure and explore opportunities for grantmakers to strengthen and sustain this fragile and troubled system. During the course of this meeting, representatives from the Institute of Medicine, which recently released a report on this topic, and the Centers for Disease Control and Prevention (CDC) discussed the role of the national public health system and reviewed weaknesses in its infrastructure. Elaborating on these points, local public health leaders offered an on-the-ground perspective of the challenges they face as they struggle to maintain and improve the health of the public at the same time as they prepare for the possibility of bioterrorism. Finally, several foundations with experience in this area shared their strategies for helping to buttress the infrastructure so vital to the health of the nation. This Issue Brief builds on a paper prepared in advance of the meeting by incorporating the highlights from presentations and discussions that took place at GIH's Issue Dialogue. It also incorporates comments and discussion from GIH's 2002 Fall Forum intensive breakout session Worst Case Public Health Scenario: Can Philanthropy Respond? Following a brief introduction to the public health system and its evolution over the past several decades, the Issue Brief discusses essential elements of the public health infrastructure, reviews the issues confronting each of these elements, and profiles various philanthropic initiatives aimed at repairing and improving the public health infrastructure. It concludes with an in-depth look at the infrastructure issues involved in emergency preparedness.

Community Health Planning↗
PubMedDate not supplied

Method for ascertaining denominators for evaluation of population coverage with pneumococcal vaccine.

BACKGROUND: Immunization programs may collect numerator data for the estimation of pneumococcal vaccine coverage, but program evaluators do not have appropriate denominator data for estimation of pneumococcal vaccine coverage, particularly among those eligible for vaccine on the grounds of having chronic health conditions. METHODS: We partitioned the Alberta population into 6 mutually exclusive groups, all but one of which met Canadian recommendations for pneumococcal vaccination. Age-sex specific prevalence rates for each group were estimated using data on chronic health conditions from the Alberta over-sample of the 1996 Household component of the National Population Health Survey, from Alberta Health and Wellness rosters of nursing home residents, and from the Alberta Health Care Insurance Plan Stakeholder Registry. We applied these to Alberta Population Projections to estimate the numbers of persons who should be vaccinated. RESULTS: The proportion of persons recommended for vaccination on the grounds of chronic health condition ranged from 1.5% among those aged less than 12 years to 36% among persons aged 80 years or older. The total number of persons recommended for vaccination at mid-year 2000 is estimated to be 638,561 (21.5% of the Alberta population). INTERPRETATION: This methodology provides denominators for the estimation of pneumococcal vaccine coverage and permits monitoring of local and regional progress towards national goals.

Adolescent↗
PubMed2003

Wanless is more.

Explore the source record for details and available documents.

Health Planning Organizations↗
PubMed2003

Health data management and strategic management in Brittany: some practical problems.

Recent changes in the organisation of the French health system include 1996's ordinances, and more recently (4th Law march 2002). The general tendency of all these reforms is the management of the health system at the regional level in France. In This paper we try to find how health data management systems could be concerned by this changes. In the first part we will explain why the health data management systems are implicated in theses changes. After that we specify the kind of information needed for strategic management of health at the regional level in Brittany. Then we discuss what information is available from all health data management systems at the regional level as far as decision making in health is concerned.

Database Management Systems↗
PubMed2003

Integrating syndromic surveillance data across multiple locations: effects on outbreak detection performance.

Syndromic surveillance systems are being deployed widely to monitor for signals of covert bioterrorist attacks. Regional systems are being established through the integration of local surveillance data across multiple facilities. We studied how different methods of data integration affect outbreak detection performance. We used a simulation relying on a semi-synthetic dataset, introducing simulated outbreaks of different sizes into historical visit data from two hospitals. In one simulation, we introduced the synthetic outbreak evenly into both hospital datasets (aggregate model). In the second, the outbreak was introduced into only one or the other of the hospital datasets (local model). We found that the aggregate model had a higher sensitivity for detecting outbreaks that were evenly distributed between the hospitals. However, for outbreaks that were localized to one facility, maintaining individual models for each location proved to be better. Given the complementary benefits offered by both approaches, the results suggest building a hybrid system that includes both individual models for each location, and an aggregate model that combines all the data. We also discuss options for multi-level signal integration hierarchies.

Bioterrorism↗
PubMed2003

The map to LOINC project.

We describe a pilot project to standardize local laboratory test names to Logical Observation Identifier Names and Codes (LOINC) at five Indian Health Service (IHS) medical facilities. An automated mapping tool was developed to assign LOINC codes. The laboratory test names not mapped to LOINC by the mapping tool were assigned LOINC codes manually. The results achieved matched current benchmarks.

Clinical Laboratory Techniques↗
PubMed2003

Epi info - present and future.

Epi Info is a suite of public domain computer programs for public health professionals developed by the Centers for Disease Control and Prevention (CDC). Epi Info is used for rapid questionnaire design, data entry and validation, data analysis including mapping and graphing, and creation of reports. Epi Info was originally created in 1985 using Turbo Pascal. In 1998, the last version of Epi Info for DOS, version 6, was released. Epi Info for DOS is currently supported by CDC but is no longer updated. The current version, Epi Info 2002, is Windows-based software developed using Microsoft Visual Basic. Approximately 300,000 downloads of Epi Info software occurred in 2002 from approximately 130 countries. These numbers make Epi Info probably one of the most widely distributed and used public domain programs in the world. The DOS version of Epi Info was translated into 13 languages, and efforts are underway to translate the Windows version into other major languages. Versions already exist for Spanish, French, Portuguese, Chinese, Japanese, and Arabic.

Centers for Disease Control and Prevention, U.S.↗
PubMed2003

HIV/AIDS Community Health Information System.

Given changes in the faces of AIDS over the last decade, it is crucial that disparities in health and access to healthcare are addressed. An Internet-based GIS was developed using ESRI's Arc Internet Map Server (Arc IMS) to provide users with a suite of tools to interact with geographic data and conduct spatial analyses related to the characteristics that promote or impede the provision of HIV-related services. Internet Mapping allows those engaged in local decision-making to: (1) geographically visualize information via the Internet; (2) Assess the relationship between the distribution of HIV services and spatially referenced socio-economic data; and (3) generate "what if" scenarios" that may direct the allocation of healthcare resources.

Acquired Immunodeficiency Syndrome↗