INDICATORS

84. DIABETES CONTROL
Definition: Proportion of adult diabetics receiving appropriate care, in terms of regular
retinal exams.
Calculation: Indicator being developed. OECD set Health Care Quality Indicators
(HCQI): retinal exams in diabetics is defined as proportion of diabetic patients (of all
patients with type I or type II diabetes) aged 18–75 who received a dilated eye exam or
evaluation of retinal photography by an ophthalmologist or optometrist in a given year out
of all patients with diabetes (Type 1 and Type 2) aged 18–75 years.
Notes: Among a longer series of process as well as outcome indicators, this one (a process
indicator) was selected by OECD as relatively feasible and reliable for international
comparisons. Also EUropean Core Indicators in Diabetes (EUCID) has among the
secondary indicators an indicator :“% with eye fundus inspection in last 12 months”.
85. POLICIES ON ENVIRONMENTAL TOBACCO SMOKE (ETS) EXPOSURE
Definition: The indicator refers to actions carried out by health (and other) policy makers
to prevent smoking exposure at community level. A composite index of enforcement of
laws and regulations on smoking restrictions in public domains and on advertisements.
The existence, implementation and enforcement of instruments and measures to prohibit
smoking in indoor environment (facility, room, etc.). The existence of instruments to restrict
smoking in designated areas with separate exhaust ventilation.
Calculation: Topic needs further development.
1) Project Environment and Health Indicators for European Union Countries, ECOEHIS:
Indicator Air_A1, defined as a “composite index of capability for implementing policies
to reduce environmental tobacco smoke exposure and promoting smoke free areas”. A
composite index on smoking restrictions in 9 public domains and on advertisements. Index
computed as a sum of 10 subset variables, including programmes to reduce smoking during
pregnancy and at home; smoking prohibition at schools, day care centres, public buildings,
public transport in urban areas, hospitals & clinics, cinemas & theatres & museums;
smoking prohibitations or restrictions (clearly separate areas for smokers) in long distance
transport, bars & restaurants; advertisement for tobacco smoke prohibitation. For each
variable score is: 0 if not existing, 1 if existing, clearly stated, partially implemented, 2 if
existing clearly stated and substantially enforced and implemented. Unit for measurement is
ordinal score of 0-20.
2) Indicators for monitoring COPD and asthma in the EU, IMCA: Interventions to
prevent tobacco exposure consisting of a) Presence of smoking restriction in specific types of
buildings and b) Existence and enforcement of laws and regulations to protect children from
tobacco exposure in public places. No operational definition.
2) Child Health Indicators of Life and Development (CHILD) project: ECOEHIS
indicator, but adapted especially for children.
3) Eurostat: information on smoking ban in public places.
4) ) An indicator based on WHO-Europe’s Tobacco control database. Precise
operationalisation to be formulated.
Notes: Topic needs much further development
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