Bridge Health Coordination highlight the three main functions of public health.
Public health policy and organisations aim to prevent disease, and to promote health and the quality and quantity of the life of populations. Public health has 3 main functions: (1) the continuous follow-up of the health populations and of specific sub-populations to be able to identify those at risk, define public health problems, set health objectives, and develop policy prioritisation and phasing of action plans; (2) the proposal of policies to tackle local, national, EU and global health problems; and (3) the creation of policies ensuring equitable and non-discriminatory access to an effective and efficient health system, that covers health promotion, prevention, care and cure. The BRIDGE Health project covers all 3 functions. In the May 2016 issue of AG, we gave an introduction to the BRIDGE Health project and described the need for and benefits of an EU health information system (EU HIS), within the current political context. In this contribution, the concepts of the EU HIS will be further explained as well as the activities of BRIDGE Health.
The idea behind an EU HIS is to understand the dynamics of population health, to understand what drives the optimisation of health systems performance and to understand how policies interact with and affect both. As such the essentials of an EU HIS are to improve people’s health and to optimise the health systems of the different EU member states by data integration, analytics and inference, research, knowledge generation and dissemination that supports multi-level policies and actions.
The scope of an EU HIS should be comprehensive, addressing health systems and population health including health status and determinants of health. Health information at individual level and population level should be considered with focus on equity and looking at societal values. The information should be used for evidence-based policy-making, (Figure 1). Data are used in research to understand the health level of the EU citizens, to understand the health gaps between EU populations and to identify the factors (health system and health determinants) affecting the health level and the health gap between populations.
Figure 1. Scope of EU health information system
BRIDGE Health has a wide scope covering the main areas of public health: health status, health determinants and health systems. The expertise of the different BRIDGE Health partners was essential not only in the development phase of the project but also in the realisation of the project, which is organised, (1) to cover both content and technical or methodological issues in health information and (2) to maximise the use of the broad expertise of the BRIDGE Health partners.
BRIDGE Health updates and improves the existing European Core Health Indicators (ECHI) knowledge and expertise. Focus is given to strengthening the scientific base that supports the effective development and use of health indicators for health policy evaluation and prioritisation by the EU and its Member States. ECHI are a set of 88 indicators providing information on health promotion, health services, determinants of health, health status and demography and socio-economic situation.
Harmonised population-based health examination surveys are an important tool for objective and reliable data that are comparable over time and between Member States. There is a need for further standardisation of the surveys and for a broader deployment covering more Member States.
The project fosters the use of environmental health surveillance in European health information by building on and expanding the work on a European-wide protocol, for human biomonitoring (HBM) surveillance in the European population and on establishing a network of European birth cohorts for environmental health research, based on the experience of COPHES/DEMOCOPHES and ENRIECO.
In the domain of reproductive, maternal, new born, children and adolescent health, we optimise the sustainability, timeliness, comprehensiveness, quality and use of perinatal health information from routine systems and research initiatives such as CHICOS, RICHE and ENRIECO.
Registers of specific chronic diseases are essential within a health information system. Therefore, BRIDGE Health focusses on population-based registries and gathers, harmonises and disseminates procedures, methods and best practices in such registries, as a common platform for the provision of community health indicators of occurrence, quality of care and outcomes of chronic diseases in Europe.
BRIDGE Health continues the work on a platform for injury surveillance (see previous IDB and JAMIE projects). It ensures the availability and EU-wide coverage of up-to-date and high quality injury data for benchmarking policies relevant for the safety of citizens in Europe and to monitor their progress in reducing injuries. By maximising synergy with existing health information repositories, it contributes to the development of a sustainable European infrastructure for health information.
The 3 remaining working domains of BRIDGE Health foster the Health System Performance Analysis (HSPA) by strengthening the use of administrative data, by piloting the use of combining data from different data sources and by seeking for best practices in HSPA:
- To strengthen the use of administrative data we provide insights on how to build a data infrastructure. We explore the integration of individual-level routinely collected administrative data with a view of producing relevant information for healthcare performance assessment, at different levels of interest (i.e. patient, provider, healthcare area, region, country). This work builds on the work already undertaken for the ECHO project;
- BRIDGE Health pilots methods to link individual level data from different sources by developing a coherent methodology to integrate health information systems from existing data sources – administrative data, survey data or registry data, both population- and disease-based;
- The evaluation of healthcare systems provides harmonised indicators, methods and tools to monitor and evaluate healthcare systems for Member States, for EU and international stakeholders to enhance evidence-based policymaking.
The different work domains in BRIDGE Health are essential building blocks for an EU health information system. BRIDGE Health uses previous successful experiences to develop not only a clear vision on the future of each specific topic it focuses on, but especially to develop a vision on a unified EU health information system.
Bridge Health Coordination
Scientific Institute of Public Health
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