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PORTUGAL Data availability by Country Report: 80% of ECHI shortlist indicators are available in international data sources. The ECHI shortlist section for which there are most data missing is Health Status. In other sections, data are missing for a few indicators only. Data availability by ECHIM Survey: 79% of ES indicators are available at a national level. Most of the data for the indicators are estimates from hospitals; there are hardly any registers in Portugal. Data for most Health Determinants indicators are produced by the National Health Survey, a series of HIS which was conducted in 2005-2006 for the fourth time. The fifth one shall be done simultaneously with EHIS, but its implementation is still not scheduled. Data availability in European context: Data availability as such in Portugal is better than European average. However, data quality must be improved. Overall situation of data sources: National patient registers do not exist. Existing data are not extensive; they are estimated from figures of a few hospitals only. HIS and HES are being fussed by frequently changing formats and poor population estimates. Health of elderly is hardly paid attention to. Health reporting: Ministry of Health (www.dgs.pt) publishes online various topic specific statistics and studies, but in Portuguese only. The major ECHI documents are also available on the website, if as outdated versions. Statistics Portugal (www.ine.pt) is publishing key facts on health care in English as a part of the Statistical Yearbook. The National Institute of Health (www.insa.pt) and the National Authority of Medicines and Health Products (INFARMED, www.infarmed.pt) have some topic specific studies available on their websites, but the material is almost exclusively in Portuguese. Main problems: Hospital data are only gathered for administrative needs by public hospitals but not private. Data management is hindered by constitution and other administrative elements; record linkage is not possible because of strict data protection law. HIS and HES lack political relevance. Ongoing and/or expected improvements: Priorities are to improve mortality data and to implement morbidity registers at first. HIS and HES are to be rebuilt and standardised. Decision has been made to provide only accurate information for international comparison. Possible solutions for implementation: The cultural paradigm must change: from statistical approach toward an epidemiological one, and the focus should be on clinical 192
decisions and less on political and administrative process. Constitution must be amended to make record linkage possible. EHIS and other HIS must be executed near the census year. HES may be done by GPs. EU level support and international examples are necessary. Country Report, data availability ECHIM Survey, data availability Health Status Health Determinants Health Care Record linkage, present Record linkage, future Implementation prerequisites Main problem: Poor health information system Main improvement: Data sources improving Main solution: Co-operation at national level 193
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Katri Kilpeläinen, Arpo Aromaa and
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Publisher National Public Health In
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ANNEXES............................
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ECHIM undertook to assess the prese
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ACKNOWLEDGEMENTS The project leader
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14 University of Brighton, Faculty
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its Work Plan 2004 (1.1. Developing
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Public health policies aim at maint
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Methods: • ECHIM Country Reports:
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ECHIM was also the scientific secre
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Jürgen Thelen, Ari-Pekka Sihvonen,
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Typically, national health informat
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2.3. Major international data sourc
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discharges and beds are part of hea
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users to assess data quality via th
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Pieter Kramers, Rutger Nugteren, Ar
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12/2007: WP Indicators meeting #5 1
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The first step was to consult the W
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3.3. Additions to the ECHI shortlis
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It was proposed earlier that the sh
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3. Many Public Health Programme pro
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Documentation Sheets are divided in
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Table 3. A Documentation Sheet for
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Relevant dimensions (subgroups) (pr
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Jürgen Thelen, Ari-Pekka Sihvonen,
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for All, OECD Health Data) and topi
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Figure 3. Availability of ECHI shor
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Figure 5. Availability of ECHI shor
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Antti Tuomi-Nikula, Ari-Pekka Sihvo
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5.2. Information derived from the E
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The Health determinants section inc
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Excluding vital statistics, there w
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5.4. Initial experiences at the sta
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) Dissemination of knowledge about
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implementation process. There was a
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Summary of Joint Action for ECHIM G
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indicators and the development of d
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Nevertheless, the intention is to d
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7.1. Current state in Europe Health
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Arpo Aromaa & Katri Kilpeläinen 8.
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80 ANNEXES
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ECHI shortlist, release of June 200
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Additions and major changes in the
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ANNEX 2: Documentation Sheets (shor
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6. POPULATION BY EDUCATION Definiti
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Calculation: Life expectancies are
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Calculation: 1) The European Monito
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17. EXCESS MORTALITY BY HEATWAVES D
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Calculation: 1) Proportion of indiv
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Calculation: 1) Age-standardised in
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27. COPD Definition: Prevalence of
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31. INJURIES: WORKPLACE Definition:
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Calculation: 1) EHIS: Percentage of
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38. PSYCHOLOGICAL DISTRESS Definiti
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41. HEALTH EXPECTANCY, OTHERS Defin
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44. REGULAR SMOKERS Definition: Per
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Calculation: 1a) For adults: Lifeti
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Notes: Exclusive versus partial bre
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Calculation: 1) Age and sex adjuste
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58. BREAST CANCER SCREENING Definit
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62. HOSPITAL BEDS Definition: The i
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Notes: Practising, professionally a
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Calculation: The indicator is calcu
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Calculation: Eurostat: a) Average l
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74. MEDICINE USE, SELECTED GROUPS D
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Calculation: (1) OECD: The indicato
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80. EQUITY OF ACCESS TO HEALTH CARE
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84. DIABETES CONTROL Definition: Pr
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ANNEX 3: Availability of the ECHI s
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26. Asthma AT BE BG CH CY CZ DE DK
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Data availability of Health service
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Page 146 and 147: figure is higher than that of the C
Page 148 and 149: AUSTRIA Data availability by Countr
Page 150 and 151: BELGIUM Data availability by Countr
Page 152 and 153: BULGARIA Data availability by Count
Page 154 and 155: CROATIA Data availability by Countr
Page 156 and 157: CYPRUS Data availability by Country
Page 158 and 159: CZECH REPUBLIC Data availability by
Page 160 and 161: DENMARK Data availability by Countr
Page 162 and 163: ESTONIA Data availability by Countr
Page 164 and 165: FINLAND Data availability by Countr
Page 166 and 167: FRANCE Data availability by Country
Page 168 and 169: GERMANY Data availability by Countr
Page 170 and 171: GREECE Data availability by Country
Page 172 and 173: HUNGARY Data availability by Countr
Page 174 and 175: ICELAND Data availability by Countr
Page 176 and 177: IRELAND Data availability by Countr
Page 178 and 179: ITALY Data availability by Country
Page 180 and 181: LATVIA Data availability by Country
Page 182 and 183: LITHUANIA Data availability by Coun
Page 184 and 185: LUXEMBOURG Data availability by Cou
Page 186 and 187: MALTA Data availability by Country
Page 188 and 189: NETHERLANDS Data availability by Co
Page 190 and 191: NORWAY Data availability by Country
Page 192 and 193: POLAND Data availability by Country
Page 196 and 197: SLOVENIA Data availability by Count
Page 198 and 199: SPAIN Data availability by Country
Page 200 and 201: SWEDEN Data availability by Country
Page 202 and 203: TURKEY Data availability by Country
Page 204 and 205: UNITED KINGDOM Data availability by
Page 206 and 207: ANNEX 5: ECHIM Products website Int
Page 208 and 209: User windows can also be found in t
Page 210 and 211: ANNEX 6: List of abbreviations Abbr
Page 212 and 213: Abbreviation EU-SILC E4SM Explanati
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