Implementation of ECHI in the Czech Republic

Implementation of ECHI in the
Czech Republic
Extended Core Group Meeting – JA ECHIM
14.-15. March 2012
Sarka Dankova, Jiri Holub
Institute of Health Information and Statistics of the Czech Republic
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Content
1. Basic information, IHIS CR
2. ECHI NIT
3. ECHI national web
4. Pilot
5. Implementation into the national DPS
6. Future
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Institute of Health
Information and Statistics CR
- The IHIS was established in 1960. It is a governmental organization
founded by the Ministry of Health. The institute is a component of
State statistical service
- The main task of the Institute are:
- the management and the coordination of the NHIS, including
further development and improvement
- conducting of health surveys;
- international collaboration in the field of health statistics
- Activities of the Institute and tasks of the NHIS are defined by:
- Act No.20/1966 Coll. on National Health Care, till 31st March
2012, from 1st April 2012 by Act 372/2012 Coll. on Health
Services
- Act No. 89/1995 Coll. on State Statistical Service
- Act No. 101/2000 Coll. on Personal Data Protection
The Institute consists of a central office and 4 regional offices
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National Health Information
System of the Czech Republic
- Collection and processing of the data concerning
health and health care
- Methodological support
- Management of health registers which are
concerned with the most important diseases and
health problems and contain individual data
- Dissemination of health information in the extent,
which respects personal data protection and
exploitation of this information for research
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National Health Information
System of the Czech Republic
NHIS provides information on following areas
- state of health of the population
- activities of health service establishments
- health service economics
- socio–demographic characteristic of the population
- living and working conditions
Data included in NHIS are obtained:
- through compulsory reports and mandatory notifications,
- from health registers and information systems
- from sample surveys of the health state of the population
- from other sectors outside health (demographic, social
and other statistics)
- from international databases
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Basic Information
IHIS CR is responsible for implementation of ECHI in
the Czech Republic. Within the National Health
Information System IHIS
- collects many health data, incl. EHIS
- disseminates health related data and indicators
via publications and DPS
- reports health related data into the international
databases
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National Implementation
Team
- NIT was created in September 2009, only IHIS and
MoH members
- Enlarged in 2010 - 10 members, 3 of them from
IHIS, 3 from MoH, 1 from NSI, 1 from health
insurance company, 1 from NIPH, 1 from National
Reference Centre
- 1st meeting was held in August 2010, second
meeting in May 2011
- E-mail communication on relevant topics, news
from the international meetings etc.
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ECHIM national web page
• http://www.uzis.cz/cz/echim/en/index.html
• Started in April 2010, updated in July-September 2011 - new revised
documents were uploaded, the Czech version of the shortlist was revised
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Piloting
• In November 2010 the Pilot data Collection has been realized. We have
calculated 14 indicators from different data sources (self reported, annual
report, registers).
• Covered reference year – 2008, 2009, 2010 for some indicators
• For selected indicators we initiated use of new data source – data from the
General Health Insurance Company
– Data are based on the administrative data - evidence of the General Health
Insurance System, which accounts more than 70 % of population. All cases when
the care is provided to the patient and the given diagnose is reported as the
reason why the care is provided are counted here (ambulatory as well as in patient
care). Additionally during the processing the data are filtered in order to have
number of persons only (instead of cases)
– This source of data was used for estimation of register based prevalence of
Diabetes, Depression, Asthma, COPD
• The final dataset was sent to the Robert Koch Institute (the coordinating
institute of ECHI Pilot). Pilot data incl. the detailed metadata have been
revised in 2011 (change in NIT team), completed and sent to RKI in the mid
October 2011
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National DPS
• First step of implementation of indicators into the
national data presentation system has been done in
November 2011. First, we identified the ECHI indicators in
current content of the national version of DPS and,
according to the recommended instructions, we used 3
simple ways of "integration" of ECHI into our DPS
database:
– A) Adding reference to ECHIM in Help text and including list of
indicators which match ECHI indicators
– B) Including "(ECHI)" at the end of titles of relevant indicators
– C) In "Select parameters" window saving groups of ECHI indicators
(ECHI "windows") which can be quickly loaded by users
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National DPS
• Ad B) In total “ECHI” has been added to more than 100
indicators included in the database
• some of them were marked with ECHI* - these indicators
are not exactly same as ECHI indicator, but differ slightly
in some aspect
– e.g. 20. Standardized death rate (per 100,000 inhabitants),
malignant neoplasms (ICD-10 codes C00-C97) – in the national
DPS we have neoplasms in total, not only malignant ones
• This version of DPS is used for internal purposes and is
distributed to national (and regional) public health
institutes and also to everybody, who asks for it
• National DPS which is uploaded on the internet is based
on different software and implementation of ECHI
indicators is not so easy here
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National DPS
Marking ECHI
indicators
Groups of ECHI
indicators
- Demography
- Mortality
- Hospitalisation
- Neoplasms – M
- Neoplasms – F
- Health Care
- Infectious diseases
in total 7 groups introduced, due to the limited number of items which can be
included in each group
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Problems
• Problems and difficulties we face at the national level are very similar to
problems observed at international level
– Problémy na národní úrovni obdobné jako na
mezinárodní (pouze pár nadšenců, jen formální
podpora, nedostatek financí na zavedení nových dat,
obtížné získaní potřebných dat ze ZP);
– Lack of support, support is only formal
– Lack of finances
– Lack of experts who could maintain national activities related to ECHI
• It is quite difficult to enlarge the number of ECHI indicators covered by the
national data sources, as we can only exploit existing data
– For introduction of new data collection we need money and legislative support
– Příliš mnoho databází (národní databáze, WHO-HFA,
OECD Health Data, Eurostat – New Cronos, UN, …)
• For the national purposes it is not necessary to have only the national ECHI
database (incl. Regional data), but it is also important to have international ECHI
database, where data for given country can be found and various countries can
be compared – Údržba, rozvoj, potřeba expertů
• At the international level it is still not very clear how detailed data (e.g. For
NUTS2, by SES, by age) will be collected. For number of ECHI indicators which
are available from the international databases at agregated level more detailed
data is not available
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Future
• Collaboration with the health insurance company(ies)
– Following the data collection made during the pilot we plan to use regularly
this data source in order to compute selected indicators
• Maintaining the national presentation tools (EHIS web pages)
• Introduction of new
web based application
for presentation of
data – supplement to
national DPS
• Instant Atlas
– To present several
groups of related
indicators
– To produce interactive
graphs, maps, tables
– Possibility of
introduction of ECHI
not currently covered
by DPS
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