Final Report Part III ECHIM Pilot Data Collection Analyses and Dissemination

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For ECHI#26, it was not differentiated between the allergic and non-allergic forms of asthma. The allergic asthma dominates in children (which have not been covered by EHIS), while 30-50% of adult asthmatics suffer from the non-allergic type, often provoked by respiratory infections. Finally, there are also mixed forms of allergic and non-allergic asthma. [2]. The President of the European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) gave a summary of the Global Burden of Asthma report and commented in 2004 that in the 20 years from the mid 1970s to the mid 1990s, the prevalence of asthma in children rose by 200%.[3] Asthma prevalence in Europe varies widely, from 18.4% in Scotland to 2.3% in Switzerland. Key findings for EU included: • The United Kingdom has amongst the highest prevalence of asthma in the world, with asthma occurring in 16% of the population • During the next decade the increase in prevalence of asthma is likely to be particularly marked in the former socialist countries and the Baltic region, as these communities increasingly adopt the Western lifestyle. The phenomenon of the quite low prevalence percentages in "new" EU countries may be explained with the ongoing transitional processes of national health care systems if compared with core EU countries, and a general limited access to health care services. A glance at Eurostat's EU SILC indicator 08 [4] "People with unmet needs for medical examination by sex, age, reason and income quintile (%)" provides the information that particular persons belonging to the lower three income quintiles report large financial barriers in the mentioned "new" Member States. So people might suffer from certain types of asthma but can neither afford MD consultations (therefore no diagnoses) nor suitable medications. If largely privatised health systems and severe out-of-pocket expenditures exclude the poor from adequate health care provision, it poses a challenge for fighting health inequalities throughout the European Union, too. Since the lowest prevalence percentages of health status indicators are mostly reported from eastern European and Baltic countries, it will be interesting to follow future developments of asthma prevalence. The next EHIS is planned for 2014, but also administrative sources or smaller projects could throw some light on the above stated association [3] between western lifestyle and asthma. 43
Administratively deduced and register-based data on asthma (data not shown) were delivered from the Czech Republic, Hungary, Lithuania, The Netherlands, Finland, and the United Kingdom, although the latter delivered estimates on totals of 6%. The UK data represent the number of individuals on General Practice asthma registers, excluding patients with asthma who have been prescribed no asthma-related drugs in the previous twelve months, as extracted from the Quality and Outcomes Framework (QOF) [5]. The different underlying methodologies might explain the strong discrepancy of figures provided by the EFA [3]. Comparisons with survey data are only possible for the Czech Republic and Hungary. Breakdown/ Country (year) Percentage CZ (2009) Percentage HU (2008) Total 3.7 2.8 Men 3.4 2.4 Women 4.0 3.0 While the latter reported data from the year 2008, which are about 30-50% below the survey results of 2009, the Czech data come close to the survey-based prevalence percentages. An interesting aspect of the administratively deduced data on asthma is the fact that it could also deliver prevalence data of the age group 0-14 years, which was excluded from EHIS. In all countries figures for children take the lead and show the impact of predominantly allergic induced asthma, as there is a general trend of increasing allergic ailments in western societies. The reasons for this increase are still under discussion [2] and comprise inter alia genetic predispositions, the impact of industrialised food production and rising consumption (convenience food, hundreds of additives) and exaggerated hygiene measures in the domestic / family environment, which both can trigger typical allergic asthma reactions. [1a+b] EHIS description http://circa.europa.eu/Public/irc/dsis/health/library?l=/methodologiessandsdatasc/healthsinterviewssurvey/ehis_wave_1/20 07-2008_methodology&vm=detailed&sb=Title and meta-data: http://epp.eurostat.ec.europa.eu/cache/ITY_SDDS/EN/hlth_ehis_esms.htm; last update 14 September 2011. 44
Page 2 and 3: Joint Action for European Community
Page 4 and 5: 1. New ECHI data: ECHIM Pilot Data
Page 6 and 7: DG Health & Consumers and DG EMPL n
Page 8 and 9: In addition to survey-derived indic
Page 10 and 11: So the entire quest was depending o
Page 12 and 13: epresentativeness through the sampl
Page 14 and 15: 1.3.1. ECHI# 21 Diabetes ECHIM Indi
Page 16 and 17: Fig.1.3.1.2 Diabetes by educational
Page 18 and 19: Fig.1.3.1.3 Correlation between BMI
Page 20 and 21: This phenomenon might be explainabl
Page 22 and 23: B Table 1.3.2 Fig. 1.3.2.1 DATA PRE
Page 24 and 25: C DATA ANALYSIS Overall depression
Page 26 and 27: months. A glance at the ICD-10 cata
Page 28 and 29: 1.3.3. ECHI# 24 Acute Myocardial In
Page 30 and 31: C DATA ANALYSIS A high percentage o
Page 32 and 33: Fig.1.3.3.2 Compatibility of submit
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Page 38 and 39: The submitted stroke attack rates i
Page 40 and 41: Fig.1.3.4.3 Differences in mortalit
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Page 44 and 45: Fig.1.3.5.2 Asthma by educational l
Page 48 and 49: [2] ERS European Lung White Book- S
Page 52 and 53: C DATA ANALYSIS Overall COPD preval
Page 54 and 55: Administratively deduced and/or reg
Page 56 and 57: 1.3.7. ECHI# 29 A-1 Injuries: home,
Page 58 and 59: Fig. 1.3.7.2 Injuries at home, leis
Page 60 and 61: Compared to the EHIS, in Switzerlan
Page 62 and 63: 1.3.8. ECHI# 29 A-2 Injuries: home,
Page 64 and 65: Fig. 1.3.8.2 Injuries at home, leis
Page 66 and 67: accidents in separate categories an
Page 70 and 71: C DATA ANALYSIS The 16-country aver
Page 72 and 73: 1.3.10. ECHI# 30 A-2 Injuries: road
Page 74 and 75: Fig. 1.3.10.2 Road traffic injuries
Page 76 and 77: The EHIS questions on “road traff
Page 78 and 79: B Table 1.3.11 Fig. 1.3.11.1 DATA P
Page 80 and 81: The non-fatal injury statistic of t
Page 84 and 85: C DATA ANALYSIS In the adult popula
Page 86 and 87: 1.3.13. ECHI# 43 Blood pressure ECH
Page 88 and 89: Fig. 1.3.13.2 Prevalence of high bl
Page 90 and 91: D REMARKS AND FURTHER INFORMATION A
Page 94 and 95: C DATA ANALYSIS The percentage of r
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population. Information on effectiv
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B Table 1.3.15 Fig. 1.3.15.1 DATA P
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C DATA ANALYSIS In the adult popula
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1.3.16. ECHI# 50 Consumption of veg
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Fig. 1.3.16.2 Daily consumption of
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The Irish data were extracted from
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C DATA ANALYSIS Overall influenza u
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for all people at high risk defined
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The lower figures reported from eas
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General remark on the preferred dat
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1.3.20. ECHI Indicator Data Sheet #
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Fig. 1.3.20.2 Colon cancer screenin
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D REMARKS AND FURTHER INFORMATION A
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[3] Eurostat database, see (http://
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C DATA ANALYSIS In a cross-country
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Further data were delivered by Icel
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1.3.22. ECHI# 72-1 Selected outpati
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Fig. 1.3.22.2 Mean number of self-r
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NB: The data from Finland originate
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Fig. 1.3.22.3 Administratively dedu
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Fig. 1.3.23.2 Mean number of self-r
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NB: The German data are the most re
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Fig. 1.3.24.2 Proportion of populat
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D REMARKS AND FURTHER INFORMATION A
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[1a+b] EHIS description http://circ
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Possible solutions and appropriate
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Table 2.1 Data sources for the ECHI
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Table 2.1 (continued) Data sources
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Table 2.1. (continued) Data sources
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2.1 Presentation of the ECHI shortl
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2.2 Content of the HEIDI data tool
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3. Lessons learned, Conclusions and
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4. Acknowledgement This work was en
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ECHI# 29 (A) 29 (B) 30 (A) 30 (B) 4
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Annex II EHIS data collection: Surv
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Annex III Data tables of indicators
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1.3.3 Data Table ECHI#24 Acute myoc
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1.3.5 Data Table ECHI#26 Asthma "Pr
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1.3.7 Data Table ECHI#29 (A) -1 Inj
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1.3.9 Data Table ECHI#30 (A)-1 Inju
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1.3.11 Data Table ECHI#30 (B) Injur
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1.3.13 Data Table ECHI#43 Blood Pre
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1.3.15 Data Table ECHI#49 Consumpti
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1.3.17 Data Table ECHI#57 Influenza
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1.3.19 Data Table ECHI#59 Cervical
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1.3.21 Data Table ECHI#71 General p
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1.3.23 Data Table ECHI#72-2 Selecte
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Annex IV List of Abbreviations Abbr
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Final Report Part III ECHIM Pilot Data Collection Analyses and Dissemination

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